Volume 9, Issue 2, Autumn 2013, Page 1-268

Isolation and Detection of Echoviruses in Acute Flaccid Paralysis among children under 15 years old in different Iraqi Provinces

Hummady A. Al-Hilaly; Razaq Hadi Eissa Al-Sayidi; FaisalG.AL- Hamadani

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 1-10

Acute flaccid paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness, affecting the muscles then progressing to maximum severity within several days to weeks and sometimes may lead to death
The objective of this study was the isolation and detection of Non-Polio Enteroviruses, The ECHO virus from three hundred stool specimens obtained from children aged less than 15 years old showing symptoms of acute flaccid paralysis (AFP) from different Iraqi provinces and characterization the different serotypes of these viruses using both tissue culture (using RD cells) and neutralization-assay methods. This was done according to protocols applied by reference laboratories recommended by World Health Organization.
The common diagnostic approach in a suspected Enteroviruses infection is the isolation of the virus (stool samples) in susceptible cell cultures such as RD cell line this cells appearance cytopathic effect (CPE ) for polio viruses and NPEVs . Virus isolation is then followed by the use of a neutralization-type assay to identify the serotype of the isolated Enterovirus, a process commonly known as serotyping.
The current study, which covered in different Iraqi provinces shows that echoviruses (ECHO) had the highest prevalence affecting 79 cases (26.33%) out of 101 NPEVs. The present study showed that the maximum frequency of ECHO virus isolation was reported in Baghdad 31 (51.67%) and Basrah 21 (52.5%)

Antiatherosclerotic potential of aspirin: Antioxidant and anti-inflammatory approaches

Najah R Hadi; Hussam H Sahib; Bassim I Mohammad

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 11-21

Objective: this study was undertaken to evaluate the effect of aspirin on the progression of atherosclerosis.
Materials and methods: A total of 28 local domestic rabbits were assigned to four groups: Group I (normal control), Group II (atherogenic control), Group III (vehicle control),Group IV (aspirin 10 mgkg daily).
Blood samples were collected at the end of experiment (8 weeks) for measurement of serum triglycerides (TG), total cholesterol (TC), HDL-C, plasma high sensitive C-reactive protein (hsCRP), plasma malondialdehyde (MDA) and plasma reduced glutathione (GSH). Immunohistochemical analysis (VCAM-1, MCP-1, and TNF-α) and histopathologic assessment of aortic atherosclerotic changes were also performed.
Results: Compared to NC, levels of lipid profile, atherogenic index, hsCRP, and MDA are increased while GSH were decreased in animals on atherogenic diet (p< 0.05). Immunohistochemical analysis showed that aortic expression of VCAM-1, MCP-1, and TNF-α were significantly increased in AC group compared to NC group (p<0.001). Histopathologic finding showed that animals on atherogenic diet have significant atherosclerotic lesion compared to NC group. Compared to AC group aspirin don’t have significant effect on lipid profile. Aspirin causes statistically significant reduction in hsCRP and MDA (p<0.05). Aspirin treatment causes significantly increase the level of GSH. Aspirin treatment significantly reduced aortic expression of VCAM-1, MCP-1, and TNF-α (p<0.05). Histopathologic examination of aortic arch showed that aspirin significantly reduced atherosclerotic lesion (p<0.05).
Conclusions: It thus can conclude that aspirin reduces lipid peroxidation, systemic inflammation and aortic expression of inflammatory markers used in this study and hence reduce the progression of atherosclerosis.

Detection of TEM and SHV genes in Escherichia coli and Klebseilla species isolated from cancer patients in Al-Diwaniya Governorate

Adnan H. Al-Hamadani; Atheer F. Al-Fatlawi

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 22-39

The aim: Detection of some genes that encode to some extended spectrum beta-lactamase enzymes in E. coli and Klebseilla spp. isolates from colon and bladder cancer patients by using the phenotypic and genotypic method
Methods: A total of 61 stool and urine samples collected from 61 patients definitely and clinically diagnosed with cancer. All these isolates were identified by conventional methods and confirmed by VITEK-2 system. Antimicrobial susceptibility testing was determined using disk diffusion methods. Investigation of production of ESBL was done by DDST methods while screening of β-lactamase genes was done by PCR technique.
Results: The study revealed that Klebsiella species and E. coli were detected in 17 (73.9 %) from urine samples, and 19 (73 %) from stool samples, the vast majority of isolates were found to be resistant to ß-lactam antibiotics (ampicillin and amoxicillin) in the primary screening test at percentage 19 (86.4 %) of E. coli isolates and 13 (92.8 %) Klebsiella spp. and all the tested isolates are resistant to a minimum of three classes of antibiotics to which they are tested, hence the isolates are considered to be multidrug resistant. the confirmative detection of ESBL by double disk synergy test showed that out of 32 β-lactam resistant E. coli and K. pneumoniae subsp. pneumoniae examined in this study, ESBLs were detected in 9 (28.1 %) isolates. The results of molecular detection of ESBL genes (blaTEM and blaSHV) by using PCR technique showed that all the tested ESBL producing isolates were carried at least one of the ESBL genes SHV and (66.7 %), TEM (55.6 %).
Conclusion: There is a high occurrence of the tow ESBL genes in clinical isolates of colon and bladder cancer patients.

The risk of conventional X-RAY for abdominal examination at different Erbil hospitals

Runak Tahr Ali

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 40-50

Thermo luminescent dosimeters (TLDs) have been used to measure the entrance surface doses (ESDs) of patients undergoing abdomen diagnostic X-ray examinations in Erbil. A total of three public hospitals and 286 patients were included in this investigation. The ages of the patients involved were from 40 years to 85 years, while their weights ranged from 64 kg to 71 kg. Mean, of ESDs are reported. The results showed that in most cases of the examinations, the individual ESD values are found to be comparable with, and higher than, those from Ghana and Tanzania, respectively.
The ranges found in this work are high and this indicates more attention needs to be given to X-ray facilities in the country.
This also suggests that radiographic departments need to review their radiographic practices in order to bring their doses to optimum levels. Effective doses were also calculated from the ESD values. The radiographic parameters used for all the patients were also compared with the European criteria. It is recommended that the tube filtration at one hospital be increased. The importance of good regulatory activities and trained personnel is stressed in this work. Apart from the fact that the data provided in this work will be useful for the formulation of national guidance levels, they also provide patient dosimeter information on healthcare level countries.

New technique use to Rapid Isolation Pneumococcus bacteria from both Pneumococcus meningitis and Pneumococcus pneumonia infections in Iraq

Mohammed Kadum Al-Araji

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 51-64

Pneumococcal pneumonia is more common in the very young and the very old ages. Pneumococci are the most common cause of meningitis in adults. Especially at risk are alcoholics and people with chronic otitis, sinusitis, mastoiditis. We compared the relative efficacy of three methods for the isolation of Streptococcus pneumoniae microorganism in both pneumococcal meningitis and pneumococcal pneumonia in both lower respiratory secretion and cerebrospinal fluid depending on results from total speciemens collected (Cerebrospinal fluid and respiratory secretion).
These 100 speciemens were subcultured on different three types of blood agar plates we found that Streptococcus pneumonia was isolated at a frequency of 70% with 5% sheep Blood Agar or 5% Sheep Blood Agar containing 5ug/ml of Gentamicin per milliliter, both incubated in 5% Co2. Anaerobic incubation of 5% sheep blood agar containing 5ug/ml of Gentamicin per milliliter enhanced the recovery rate of Streptococcus pneumonia to 90%. The differences in the recovery rates of Streptococcus pneumoniae isolated from both pneumococcal meningitis and pneumococcal pneumonia by various culture media and conditions were analyzed.

Effect of Amlodipine drug on male sex hormones of hypertensive patients in Al-Najaf province

Karrar Saleem Zayed Al-Shebli

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 65-79

The current study was carried out in Al-Sader teaching Hospital in Al-Najaf province during the period 2011/6/5 till 2011/12/2. The study was undertaken to evaluate the effect of Amlodipine drug that’s uses to treatment of hypertension on male sex hormones (LH ,FSH and testosterone) in a number of males hypertensive patients .
Forty five males patients who are took this drug to lower their high blood pressure participated in the study , their ages ranged from (31-60) years divided into three groups (15 male/group) according to amlodipine doses 2.5, 5 and 10 mg once daily .Also contribute fifteen health males as a control subjects, their ages ranged from (30-63) years.
Results of the study revealed a significant decreased of LH, FSH and testosterone activities in a patients who are treated with two highly doses of amlodipine when compared with control group, also when compared high dose group with low dose group. Regarding the effect of different ages of male hypertensive patients who are treated with amlodipine on these hormones , the findings were indicated a significant decreased of these hormones levels at the highest ages especially at 51-60 years old. On the other hand, the results obtained there were an effect of interaction between different doses of amlodipine and ages of hypertensive patients that treated with it on male sex hormones levels particularly at the higher doses and ages , and this effect was represented by decreased of these hormones levels. The study was suggested that the therapy with amlodipine may be causes defect in male reproductive system that indicated by inhibition of male sex hormones levels and this effect was amlodipine doses and patients' ages dependent.

Extraction and Identification of A Flavonoid compound from Oak Plant(Quercus infectoria Oliv.) and study Of Its Antibacterial Activity, in vitro

Rajaa A. Hussein

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 80-94

A flavonoid compound was isolated from oak plant (Quercus infectoria oliv.) (Fagaceae) stem barks using ethanol alcohol as a solvent, the isolated compound was identified using conventional characterization methods, such as Thin Layer Chromatography(TLC),Ultraviolet-Visible (UV-Vis) and Fourier transform infrared spectroscopy(FT-IR), as well as, some biochemical assays using color reagents.
Antibacterial activity of extracted flavonoid was carried out against two types of reference strains bacteria: which are Gram positive bacteria (Staphylococcus aureus ATCC 25923) and Gram negative ( Escherichia coli ATCC 25923), the results shows that the extract of oak barks has good a antibacterial growth activity in which gram positive bacteria are more susceptible to the oaks extract than Gram negative (31 mm and 19mm, respectively).

Methotrixate for nonsurgical management of ectopic pregnancy

Ariana Kh. Jawad

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 95-108

Systemic Methotrexate has been widely used to treat ectopic pregnancy.The aim of current study were to evaluate the safety and efficacy of single dose intramuscular methotrexate as a treatment option for early unruptured ectopic pregnancies.
From 1st of January 2007 to 1st of January 2009 at Maternity teaching Hospital-Erbil, a case cohort prospective study was conducted on 60 patients with small unruptured ectopic pregnancies treated as in-patients with single dose of Methotrexate therapy.
Ectopic pregnancy was diagnosed by both transvaginal ultrasound for the size and volume of the gestational mass and β-HCG measurement. Intramuscular methotrexate 50 mg/m2 was administered on days 1 and Serial ß-hcg was repeated on days 4 and 7, If the β-HCG on day 7was at least 15% lower than that on day 4, the patient was regarded as treatment success, and Follow-up serum ß-HCG was performed weekly until become negative ( value of <15 mIU/ml). while additional doses(second dose) of methotrexate were given on day 7 If the ß-HCG level on day 7 was the same or higher or less than 15% lower than that on day 4.
The success rate of systemic methotrexate (single dose) was 75%(n-45), 25%(n=15) exposed to 2 or more doses of methotrexate ,16.6%(n=10) of patients exposed to multidose methotrexate respond to treatment, remain only 8.3%(n=5) not respond to multidose treatment they were treated surgically ,in which 2 cases of them operation done for them on their request after one dose of methotrexate, and other 3 cases were failed to respond to medical treatment after receiving 3 dose of methotrexate. The over all success rate of treatment in our study(medical treatment) was 91%(n=55).Success rate was higher in patients whom with β-HCG was ≤ 1500 mIU .Treatment was well-tolerated; most side effects were reported as mild and transient.
All cases respond to methotrexate reported satisfaction with this regimen. Within two years follow up visit 38 cases become pregnant , 2 of them developed recurrent ectopic pregnancy.

Acute Meningitis in Children:Clinical and Laboratory Profiles

Haider Nadhim Abd

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 109-123

Background: Meningitis is a significant cause of morbidity and mortality in children around the world . Early diagnosis and treatment are the most important way in prevention of the complications.
Objective: To estimate the frequency and types of meningitis, to describe various clinical and laboratory parameters, and to analyze mortality and early complications of childhood meningitis.
Patients and methods: One hundred Children aged 1 month-15 years admitted to AL-Zahra Teaching Hospital in Wassit, with clinical suspicion of meningitis during the period from 1st January 2009 to 1st January 2010 were included in this study. They were subjected to clinical examination , blood tests and cerebrospinal fluid tests (CSF) which include: biochemical, bacteriological, and serological tests.
Results: Thirty of the patients had bacterial meningitis, 34% had viral meningitis, 36% had partially treated bacterial meningitis. Majority of the patients admitted in January and February. Fever was the most common presenting symptom (94%) , followed by vomiting in 64%, poor feeding or appetite in 65%. Irritability and bulging fontanel were the main signs in those children below one year. Neck stiffness and positive kernig sign were the main signs in children above one year. The results of Cerebrospinal fluid studies in patients with bacterial meningitis were as following : (gram stain was positive in 18 (60%) patients, culture was positive in 22 (73%) patients, C-reactive protein (CRP) was positive in 23 (77%) patients). Serum C-reactive protein was positive in 16 (53%) patients with bacterial meningitis. Haemophilus influenza (H.influenza) was the main causative agent of bacterial meningitis. The main complication was recurrent convulsion (27% of bacterial meningitis,8% of viral meningitis, 5% of partially treated bacterial meningitis).Two cases required admission to intensive care unit. The overall mortality rate was 8%.
Conclusion: H. influenza type B is the leading causative agent of bacterial meningitis. Fever was the most common presenting signs , recurrent convulsion was the most frequent complication in all age groups and in all types of meningitis. Positive C- reactive protein in the Serum and CSF was mainly found in patients with bacterial meningitis.

Epidemiological study in roseola infantum in Babylon

Muder Hassan Noor; Wisam Hamzah Hamad; Adil Jabbar Hussein

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 124-131

Roseola is a mild febrile exanthematous illness occurring almost exclusively during infancy. Among the many alternative names for the disease are exanthem subitum (indicating the sudden and surprising appearance of the rash), the rose rash of infants and pseudo-rubella. Human herpesvirus 6 (HHV-6) is the etiological agent of roseola infantum. The aim of this study is to predict the disease early by the time of high incidence of this disease, the common age of presentation and the commonest clinical findings. A cross-sectional study was conducted in Babylon Teaching Hospital for Maternity and Children in Babylon city for 12 months, from the 1st March 2009 to the 1st February 2010.
The study involved 48 cases of roseola who visited the outpatient clinic which were followed up for 3 days (22 cases were admitted to hospital and 26 cases were reevaluated after a second visit). In the result of this study we found roseola was highest in infants with age group 10-12 months. The cases in urban area is more than rural area, it occur more in the period from April to June. There was no significant sex predominance in the incidence of the disease. The most common clinical finding were occipital lymph node enlargement in all cases (100%) and cervical lymph node enlargement in (89.6 %) infants.

Association of lewis phenotype blood groups with recurrent urinary tract infection in female

Naseer J. H. Al-Mukhtar; Abdul Razzak S. Al- Salman; Kholod hussian Ali AL-khafag

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 132-148

Background: Histo blood group antigens with carbohydrate molecules are found on the surface of RBC and uroepithelial cells, which influence human susceptibility to recurrent urinary tract infection( RUTI).
Objective: Of this study was to determine if a link exists between susceptibility to RUTI and host genetic phenotypes that define either an individual’s ability to respond immunologically to some antigens or the composition of host cell surface molecules.
The interaction of pathogen and erythrocyte membrane may reflect antigenic similarity, adhesion through specific receptors, or modulation of antibody response, Detect the ABO blood group distribution and RUTI in accordance to lewis phenotype antigens,
Methods: The studied groups attended to Babylon Maternity and Pediatric Teaching Hospital from November, 2010 to November 2011. The study is carried out on 22 female as control groups, and 52 female as patient group. All patients had a history of RUTI, defined as a minimum of three infections in the previous year; however, most patients experienced more than three UTIs per year and had recurrent infections for several years. Results of excretory urography or renal ultrasound and cystoscopy performed on all patients were normal or showed only inflammatory changes. also using physical examination and urinalysis. Circulating immunoglobulin concentrations (IgG) was evaluated by applying Mancini single radial immunodiffusion technique for a RUTI patients and control involved in this study.
Results: - Regarding lewis phenotype blood group in RUTI women , there's association between non-secretor phenotype and predisposition to RUTIs in post menopause women and disappears in pregnant women in patient and control, while there's no association between secretor phenotype and predisposition to RUTIs in young women. The important result in this study appearance percent of weak secretor phenotype was (14%) in RUTI and control women.
WBC count shows a highly significant increase (p<0.001), significant increase (p<0.05)of granulocyte and lymphocyte count in RUTI women in patents comparing with control groups. and significant increase (p<0.05) in secretor than non-secretor RUTI groups of WBC ,lymphocyte and granulocyte count . Also it was found that RUTI was associated with an increase in IgG concentration more than normal IgG concentrations among secretor RUTI patients revealed an increase more than non-secretor RUTI .While, urine analysis shows all patents were suffering with pyurea , these severity was highly significant increase (p<0.001) in non-secretor than secretor RUTI group .
Conclusion: the results of this study supports Predisposition RUTI has been associated with ABO histo Blood group and secretor status. The distribution of non-secretors was significantly higher in women with RUTI Than in the control, and higher in postmenopausal and pregnant women than in young women. These results suggest that non-secretor status is associated with the genetic susceptibility to RUTI.

Phenotypic detection of extended –spectrum beta-lactamase production in Proteus. mirabilis isolation from Patients with Significant Bacteriuria in Najaf provina

Ahmad Aleiwi Hussein

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 149-160

250 mid-stream urine samples were collected from patients suspected of urinary tract infection (UTI) who were attended to Three hospitals (Medical Al-Sader City, Al-Hakeem, and Al-Zahra Maternity and Children) in Najaf provina during the period of October 2011 to January 2012 and screened for the presence of Proteus mirablis .The growth of ≥105 colony forming units/ml was considered as significant bacteriuria.
A total of 198 (79.2%) significant bacteriuria were detected. The study showed higher incidence of UTI in females 129 (65.2%)than males 69 (34.8% )However , 52 (26.3%) isolates of Proteus mirabilis , 146 (73.7%) isolates other species pathogens.
The 52 isolates of Proteus mirabilis were tested for their antibiotic resistance against 11 antibiotics by the Kirby-Bauer disk diffusion test. All the isolates were found to be resistant to at least 5 antibiotics to which they were subjected. Therefore, all these isolates were considered to be multidrug resistant.
The majority 39 (75.0%) isolates of Proteus mirabilis were able to produce β-lactamase enzymes with rapid iodometric method.
All isolates of Proteus mirabilis were tested for their ability to produce Extended-spectrum β-lactamase . The result showed that 18 (34.6%) isolates were able to produce ESBLs.

Blastocystis hominis infections among patients in Duhok City / Kurdistan Region – IRAQ

Adel T. M. Al-Saeed; Qais I. Ismaeel; Ghazwan F. Ahmed

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 161-170

A total of 610 patients of different age and sex attending the central Laboratory / Shilan Private Hospital and Hevi Pediatric Hospital – Duhok Governorate suffering from gastroenteritis sumptomes were investigated by direct stool examination.
The samples were collected from 350 children and 260 adults during the period from April to November 2010.
All stool samples were examined microscopically by the direct method for identification of B. hominis and for the presence of other intestinal parasites.
The number and percent of infection rate with B. hominis among the examined samples (610) was 31(5.08%) in both of adults and children groups, while the infection percent among children and adults were 14(4%) and 17(6.5%) respectively.
Regarding to the children, the age group > 1 - 10 year showed the Highest rate of infection 12(5.02%) and the lowest rate was in children up to one year was 1 (1.07%). The number and percent of infection among adults were 5(10.41 %) among age group of > 30 – 40 year and the lowest were 4(7.01 %), 2( 7.40 %) among age groups < 20 – 30 year, < 40 year respectively.
The number and percent of the infection among males were 9 (4.63%) while among females were 3 (3.19%) among children. The number and percent of the infection among males were 10 (7.29%) while among females was 7 (5.69%) among adults. The vacuolated type was only recorded from all examined stool samples during this study.
Out of 610 stool samples examined 166 (27.21%) were positive with Other intestinal protozoa. The number and the percent of infection were 59 (22.69%) among adults and 107 (30.57%) among children.
The most prevalent pathogenic intestinal parasites were Entameba
histolytica and Giardia lamblia. The abdominal pain and distention were the most frequent symptoms associated with B. hominis infection followed by diarrhea.

Asses microvascular densities in breast ductal cell carcinoma (using CD 31 & VWF immunostain), in correlation to ER status

Ali Zeki Naji; Hedel A. Kerbel

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 171-180

For three years duration( Jan 2009 – Des 2011) , 50 cases of ER positive cases and 50 cases of ER negative cases were collected among mastectomy samples from patients with invasive ductal carcinoma of the breast which were received by the department of histopathology in AL -Hilla teaching hospital. microvessel density (MVD) estimation for all cases using CD – 31 & VWF immunostain, and the quantitative analyses of the microvessels in the 10 high power fields revealed the median for vessels count identified by anti-CD31 in ER-positive & ER- negative groups were( 18, 30) respectively, while median MVD as it expressed by anti-VWF in ER-positive & ER-negative groups were (19, 33)
respectively. There were greater concentrations of microvessels stained brown by both antibodies (CD31 & VWF) in estrogen receptors- negative group compared to the estrogen receptors – positive group. This difference was statistically significant (p< 0.001) .The highest values of MVD were obtained using anti-VWF other than anti-CD31 & the median MVD was significantly different between those two antibodies (p <0.005). So the conclusion is that, high vessels count represent increased tumor angiogenesis and correlated with estrogen status, and tumor grade. Microvessels quantitation may be an additional prognostic factor especially when it combined with more established parameters like estrogen receptor status.

Effectivness of 10% povidone iodine as ascolicidal agent in hydatid cyst surgery in compared with other scolicidal agents

Ali Nayyef Assi

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 181-195

Hydatid disease or Echinococcal disease, is a parasitic disease that affects both humans and other mammals such as sheep, dogs, rodents and horses.[1] There are three different forms of Echinococcosis found in humans, each of which is caused by the larval stages of different species of the tapeworm of genus Echinococcus[1].This study was done in the AL-Husseinteaching hospital (AL-Nassiyria)during3 years (between 1st January 2004 to december2006) and follow up for5 years,120 patients [70 females and 50 males] ages range between 12years to 56years presented withhydatid cyst in the liver only we concentrate on the hydatid cyst of liver( un complicated cases) confirm the diagnosis by U/S and CTscan ,and after surgery follow upalso by U/S and CTscan for 5 years.
Povidone-iodine (PVP-I) is a stable chemical complex of polyvinylpyrrolidone (povidone, PVP) and elemental iodine. It contains from 9.0% to 12.0% available iodine, calculated on a dry basis.[1]To evaluate effectiveness of 10% povidone iodine as ascolicidal agent in liver hydatid cystsurgery in compare with hypertonic salinesolution and alcohol,povidone iodine have a better effect as a scolisidal effect because(1)there'sa lowerrecurrencerate during 5 years post operativlyfollow up (2) there is little post operative complication related to the povidone iodine(3)mild direct effect on the liver cell during six months follow up postoperativelyaccording to the liver function tests results as compare with other scolicidal agents, so we can use povidone iodine10% in surgical operation for hydatid cyst as ascolicidal because it highly effective against the scolices,little intra or post operative effects on the liver cells , cheep and widely available.

Comparisons of quality of life for schizophrenic outpatients and a control population

Mohammed Dawood Jasam

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 196-207

The study of quality of life (QOL) and the focus on patients' subjective sense of well-being is a new approach to understand the impact of the illness.87 patients suffering from schizophrenia, attending the psychiatric outpatient unit of Al-Rashad Teaching Hospital in Baghdad and 100 control formed the subjects.QOL of the patients and the control sample were assessed using the WHOQOL-100Arabic version. Patients group scored lower than control on all facets of QOL For the control group the highest scores on facet of self-esteem, while the lowest scores on facet of security.
For the patients, the highest scores on facets of; religion and dependence on treatment or medications.

Sublay versus onlay mesh repair of ventral hernia

Furat Shani Aoda; Alaa Sharif Ibrahim

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 208-216

Ventral hernias are commonly encountered in surgical practice. The estimated incidence of ventral hernia is 15-20%. Although a wide variety of surgical procedures have been adopted for the repair of incisional hernia, but the implantation of prosthetic mesh remains the most efficient method of dealing with ventral hernia. Our study is to evaluate the technique of preperitoneal (sublay) mesh repair of ventral hernias and compare it to onlay mesh repair.
The prospective study was carried out in 102 patients of incisional and paraumblical hernia.52 patients were managed by onlay mesh repair and 50 patients were managed by sublay mesh repair.
Observation in both groups were made with regards to duration and ease of operation, placement and duration of drainage, wound complications, hospital stay, and recurrence. Follow up every three month for 12-24 months was done .
In onlay group drain was removed after 2-5 days except one patient with large incisional hernia drain was removed after 14 days .In sublay group drain was removed after 2-3 days. Post operative complications like seroma & wound infection were comparable in both groups. In sublay group Seroma formation was 2%(one patient only) . Wound infection was2% (one patient only).No septic mesh was removed in the series. In onlay group seroma formation was24%(12 patients) most of seroma occur in large incisional hernias repair, wound infection was 4% (2 patient s)and one septic mesh was removed. In sublay recurrence rate was 0%,in onlay recurrence rate was 2%(one patient).
Sub lay mesh repair is associated with less chances of seroma formation and almost no recurrence with low post operative complication like infection and wound edge necrosis.

Oxidant/Antioxidant Status, C-reactive Protein and Serum Leptin in Patients with Pulmonary Tuberculosis: Effect of Vitamin E Supplemention

Imad Abdul-Jabbar Thanoon; Eman Abdulla Solaiman

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 217-227

Objectives: To evaluate the effects of pulmonary Tuberculosis (TB) on markers of oxidative stress (malondialdehyde "MDA" and total antioxidant status "TAS"), high sensitivity C-reactive protein (hs-CRP) and serum leptin and to compare the effects of standard intensive 2 months anti-TB therapy with the standard intensive anti-TB therapy plus vitamin E supplementation on the parameters.
Methods: Two group of patients with active pulmonary TB from the Advisory Clinic for Chest and Respiratory Diseases in Mosul City were included in this study.Group one consistent of 38 patients and group two consistent of 28 patients, with forty healthy age and sex matched subjects as controls. Assessment of concentrations of MDA, TAS, hs- CRP and leptin were done for both patients and controls. After two months with either the traditional intensive therapy (isoniazid "INH" 75 mg, rifampicin 150mg, pyrazinamide 400mg and ethambutol 275mg ) 4 tablets as a single dose in the morning with vitamin B6 10mg daily or , the intensive traditional therapy plus vitamin E 400 IU/day as a supplementation therapy, the same parameters were reassessed for the patients. Body mass index(BMI) were calculated by using special equation.
Results: After 2 months of either the traditional therapy or the traditional therapy plus vitamin E ,there was a significant reduction in MDA and hs-CRP with significant increase in TAS ,leptin serum levels and BMI in patients with pulmonary TB in comparison to pre-therapy stage and the percentage of variation shifted towards the beneficial effect of vitamin E add- on therapy group.
Conclusion: Active pulmonary TB associated with oxidative stress and an increase in the levels of hs-CRP and both traditional therapy or the traditional therapy plus vitamin E resulted in a significant improvement in oxidative stress and cause suppression of inflammatory responses with the beneficial effects shifted towards the add-on of vitamin E as a supplementation therapy.

Upper Respiratory tract infection in breast feed baby versus formula feeding

Hassan Raji Jallab

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 228-236

Four hundred thirty three children has attending the health center of Jordan university of science and technology for a period between (Nov 1st –Nov30th) 2009.100 of them complaining of upper respiratory tract infection which included in this study .
We studied the effect of feeding types on the frequency of upper respiratory tract infection , the children who exclusively fed for the 1st 6 months of life had lower rate of upper respiratory tract infection compared to bottle feeding .
A strong association was found for protection against upper respiratory tract infection by breast feeding versus bottle feeding .The collection of data were prospective based on valid questionnaires and methodologies.
Our finding supports the hypothesis that predominant breast feeding protecting against occurrence of upper respiratory tract infection , additional large controlled clinical trials are required to confirm these findings and to understand mechanism of breast milk protection .

Immunohistochemical study of CD15 expression in CD30+ classical Hodgkin's lymphoma

Thaeer Jawad Kadhum; Aws Rassul Hussain; Nawar Jamal Naser

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 237-244

Background: Hodgkin lymphoma (HL) is a histologically defined B-cell neoplasm that includes two distinct types of disease, classical and nodular lymphocyte-predominant.
Aim of the study: To evaluate the immunohistochemical expression of CD15 in CD30+ classical Hodgkin’s lymphoma.
Patients and Methods: This retrospective study included revision of 52 lymph nodes specimens from patients newly diagnosed with HL from January 2005 to September 2010.
These samples were collected from Al-Yarmouk Teaching Hospital, Baghdad Medical City and Al-Atheer private laboratory. Only well-preserved samples that stood a retrospective confirmatory morphological revision and revealed IHC CD30 stain {from DAKO} positive reactivity were included in this study.
All biopsies were formalin-fixed and paraffin embedded. A 4 micron sections obtained and stained with hematoxylin and eosin and CD15 monoclonal antibody {from DAKO} according to the kit-included instructions.
Results: This study revealed that the CD15 positive classical HL are 24 (75%), 10 (100%), 6 (100%) and 0 (0%) for MC, NS, LD and LR respectively.
Conclusions: All cases of cHD should undergo immunophenotypic analysis for CD15 in addition to CD30 antigen.

In vivo cytogenetic and genotoxic effects of curcumin on mouse bone marrow

Mohammed Subhi Mohammed

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 245-260

Objectives: Studying the cytogenetic effects of Mytomycin-C by using 2mg/kg by study of (mitotic index, chromosomal aberrations and micronucleus assays) on mouse bone marrow cells (in vivo) and Studying the cytogenetic effects of crude extract of Curcuma longa on mouse bone marrow cells and Studying the ability of crude extract of C. longa in reducing the genotoxic effects induced by Mytomycin-C by combination treatment on mouse bone marrow cells.
Material and methodology:
Administrative Arrangement: analytical study to period )1 / 5 / 2011 to 1 / 1 / 2012(conducted in Al-Nahrain research Centre for biotechnology, Baghdad, Iraq .
Methodology: distributed of mice on equal group each group contain five animals, negative control and injected Phosphate Buffer Solution only and positive control injecte Mitomycin - C 2mg/kg and four groups injected by ethanolic crude extract by uses concentration (400, 200, 100 and 50 mg/kg) depend on LD50 of curcumin extract and study
interaction between crude extract and MMC after and befor treatment
and determination of active the extract in preventiveor inhibition of side effect Mitomycin - C in vivo. Results: The results indicated that MMC has clear effects in reducing mitotic activity, increased spontaneous chromosomal aberration and increased micronucleus in mouse bone marrow cells (in vivo), these effects suggested that the drug has a genotoxic effect, the cytogenetic effects represented by mitotic index, chromosomal aberration and micronucleus (Mitotic Index, Chromosome abberations, Micro Nucleous) on mouse bone marrow cells (in vivo) of positive control Mitomycin-C use 2mg/kg for one day and gave 1.81% for MI and 4.12% for CAs and 8.13% for MN, and the cytogenetic effects of ethanolic crude extract of Curcuma long extract by administration the animals crude ethanolic extract at different concentration (50, 100, 200 and 400 mg/kg) for 7 days i.p., 50mg/kg was choice to as best dose which there ratio considered increase Mitotic Index (5.40%) and reduce Micro Nucleous (1.801%) and Chromosome abberations (0.774%) relatively was like negative control, the Interaction effect between extract administration pre and post treatment with drug (MMC) was estimated in cytogenetic parameters on mouse bone marrow cells, which gave a protective efficient against the genotoxic effect of Mitomycin - C in mouse bone marrow cells which gave 90% for M.I and 97.55% for CAs and 97.64% for MN, this effect was more efficient in post-treatment than in pre-treatment, ethanolic crude extract of C. longa extract had genotoxic effects at high doses exess of 50 mg/kg and showed Ethanolic crude extract C. longa was considered as fundamental biomutagene in the first degree and desmutagene in second degree as a result of its ability to increase mitotic activity, decrease micronucleus frequency and repair chromosomal aberration in mouse bone marrow cells.

Efficacy of oral mefenamic acid in treatment of rash of Gianotti–Crosti syndrome: A prospective noncontrolled case-series study

Usama Abdul-Jaleel

Al-Qadisiah Medical Journal, Volume 9, Issue 2, Pages 261-268

Background: Gianotti–Crosti syndrome (GCS) is a characteristic cutaneous response to viral & non-viral infection mainly affecting children .No treatment appears to shorten the course of the disease which lasts 3-8 weeks .Mefenamic acid is NSAID which acts as competitive inhibitor of prostaglandin biosynthesis.
Objective: To assess the efficacy and safety of oral mefenamic acid 50 mg twice a day in the treatment of (GCS) for 10 days
Methods : In this prospective non-controlled case series study, 36 patients were identified as having Gianotti–Crosti syndrome by dermatologist in Al-Diwanyia Teaching Hospital , from January 2012 to May 2013 and they have been treated with oral mefenamic acid 50 mg twice a day for 10 days.
Results : 36 patients entered the current study. The mean age of the patients was 2 1.2 ( 1 - 5.5 ) years. There were 19 ( 52.8 %) females and 17( 47.2 %) males. Complete clearance of the rash of GCS at all sites was seen in 33 patients ( 91.6 %) within 10 days of initiation of the therapy, leaving the the skin with fine desquamation (P<0.05) .Two patients experienced no change in the rash until after 3 weeks it got resolution of the rash and one patient get his rash resolved after one month. None of the patients suffered adverse effects during the usage of treatment and the period of the follow-up.
Conclusion : oral mefenamic acid seems to be effective in treatment of Gianotti–Crosti syndrome