Volume 10, Issue 1, Spring 2014, Page 1-252

Glycemic Control, Serum Leptin and Lipid Profile in Patients With Pulmonary Tuberculosis: Effect of Initial Two Months Anti-Tuberculosis Therapy

Imad Abdul-Jabbar Thanoon; Aseel Abed-Alelah Aded- Alrahman

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

Objectives:To evaluate the effect of pulmonary tuberculosis (TB) on glycemic control (fasting serum glucose "FSG", serum insulin, C-peptide and insulin resistance), serum leptin and lipid profile (total cholesterol 'Tc', triglyceride "TG", low density lipoprotein cholesterol "LDL-C", high density lipoprotein cholesterol "HDL-C" and atherogenic index AI) and to evaluate the effects of intensive 2-months anti-tuberculosis therapy on these parameters in comparison to healthy controls.
Methods:Forty three patients with active pulmonary tuberculosis from the Advisory Clinic for Chest and Pulmonary Diseases in Mosul City were included in this study, with 40 apparently healthy age and sex matched subjects as controls. Assessment of serum concentration of FSG, C-peptide, serum insulin levels and insulin resistance, with serum leptin and lipid profile were done for the patients and controls. After two months with intensive anti-TB therapy (isoniozid "INH" 75 mg, rifampicin 150mg, pyrazinamide 400mg and ethambutol 275mg) 4 tablets as a single dose in the morning with vitamin B6 10mg daily, the same parameters were reassessed for the patients. Body mass index were calculated for both the patients and control using especial equation.
Results:With the exception of body mass index (BMI), there was insignificant differences with regard the parameters of glycemic control, serum leptin and parameters of lipid profile between newly diagnosed patients with pulmonary TB in the pre-therapy stage and healthy controls.
After 2 months of therapy, there was a significant increase in BMI, serum leptin and serum TG with insignificant differences in the other parameters under study.
Conclusion: In this study active pulmonary TB as a disease did not affect parameters that represent glycemic controls, serum leptin and lipid profile. Intensive 2-months therapy with anti-TB drugs brings about a significant increase in BMI, serum leptin and TG with insignificant effect on glycemic control, and other parameters of lipid profile.

Pre- and post-pubertal Upregulation of testicular IGF-1 gene using passive immunization against inhibin α subunit in neonate rats

Jabber A. A. Al-Sa; aidi; Mohammed-Salih; A. H. Al-Ali

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 11-27

The present study has been conducted to evaluate the effect of neonatal passive immunization against inhibin α subunit on testicular mRNA expression level of IGF-1 gene during prepubertal and pubertal stage in male rats. Thirty male rats (weighted 21.5±1.32 g, aged 15 days) were randomly assigned into two equal groups; antiserum treated and control groups, received inhibin-α antiserum (100µl of physiological saline containing 1µg antiserum, i.p.) and physiological saline (100µl, i.p.) at the 15th and 18th days old. Five males from each group were sacrificed at the 23th, 30th and 50th days old. Testis samples were obtained for evaluation of mRNA expression level of IGF-1 gene using RT- PCR. Testis of 50d treated male rats showed higher expression level of IGF-1 gene compared with control, while 23d and 30d showed insignificant changes between studied groups. In conclusion, passive immunization against endogenous circulating inhibin during prepubertal age can perform potent role in testicular functional status and performance in the males after puberty.

Pulmonary Function Tests Abnormalities Predictors In Smoker Patients

Hawa A.A. Al-Dhahir; Ali.S. Baay; Amjed H. Abbas

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 28-42

Background: Smoking remains the most preventable cause of premature death and morbidity in the US and the developed world. Cigarette smoking is the most well known risk factor for accelerating lung function decline in adults. This study aimed to evaluate pulmonary function tests abnormalities predictors in smoker patients
Materials and methods: This case-control study was done in Merjan teaching Hospital, Babylon, Iraq, in the period from December 2010 to March 2012. The study included 182 patients who were divided into 114 patients in obstructive group and 68 patients in restrictive group. Duration and amount of smoking were evaluated by pack years. Spirometry was done for each patient. The effects of smoking were compared between obstructive and restrictive chronic lung diseases.
Results: The ages of patients in both groups ranged from 31-70 years. Most of patients were males (65% in obstructive group while 58% in restrictive group). There was significant correlation between pack years and degree of dyspnea (functional state),in addition there was significant correlation between pack years and severity of obstructive and restrictive diseases.
Conclusions: The results of this study indicate that effects of smoking were more in obstructive group than restrictive group. It was established that lung function (FEV1,FVC and FEV1%FVC) decreases with increasing number of pack years. Lung function was related inversely to pack years of cigarette use

Detection of Ventricular tachyarrhythmia in early five years of Diabetes MellitusUsing Holter Monitoring

Hussein A. Naser

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 43-49

The study was carried in Al Najaf Diabetic Centre in Sadar Teaching Hospital in Najaf . from March 2010 to March 2012 .
Aim of the study is to understand the associated ventricular tachyarrhythmias as they important risk factors and can related to sudden death in diabetic patients . we studied 60 patients in early 5 years of disease with other 60 normal persons of same age using Holter Monitor for 24 hours ECG monitor. The results showed occurrence of more ventricular premature contractions in diabetic patients compare to the normal persons and more in female patients .

Efficacy of oral doxycycline in treatment of red face syndrome subjects : A prospective noncontrolled case-series study

Usama Abdul-Jaleel; Aqeel Agab Sarhan; Safaa H. Ganduh

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 50-58

Background: Red face syndrome is a chronic burning erythema of the face that occurs after prolonged application of topical corticosteroid and characterized by flare-ups after trial of corticosteroid withdrawal.It is mediated by nitric oxide overproduction. Doxycycline was found to inhibit inducible nitric oxide synathase .
Objective: to assess the efficacy of oral doxycyline and corticosteroid withdrawal in hastening the resolution of red face syndrome
Methods : In this prospective non-controlled case series study, 68 patients were identified as having red face syndrome by dermatologist in Al-Diwanyia Teaching Hospital , from July 2011 to September 2011 and they have been treated with oral doxycycline and corticosteroid withdrawal.
Results : 66 patients completed the study while 2 patients stopped treatment because of severe gastric upset .Oral doxycycline was significantly able to decrease the total score of the clinical complaints after 4 weeks treatment (7.3 0.46) compared to baseline (12 0.32) (P<0.05) in patients with further significant decrease in the total scores at 8 weeks (3.9 00.49) compared to baseline (12 0.32) (P<0.05).
Conclusion : oral doxycycline seems to be effective in treatment of red face syndrome

Pre valence of Genital Mycoplasma, Mycoplasma hominis and Ureaplasma urealyticum in Women in Al-Qadisiya Province. A New Record

Habeeb S. Naher; Adnan H. Al-Hamadini; Ibtisam Habeeb Said

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 59-66

Seven hundred and thirty five samples included endocervical, high vaginal, urethral and urine, were collected from married 530/735 (72.1%) and unmarried women 205/735 (27.9%) who admitted to Al-Diwaniya Maternity and Pediatric Teaching Hospital, Al-Diwaniya Teaching Hospital, and private clinics in Al-Qadisyia province, through a period of twelve months (from April 2011 to April 2012) in an attempt to isolate these bacteria.
Through the study two types of media were used for cultivation of the genital Mycoplasma.
The incidence rate of genitourinary infection caused by U.urealyticum was significantly higher (79.4%) while the incidence caused by M.hominis which a The main goal of this study was to detect and isolate the M.hominis and U.urealyticum from genitourinary tract of women Al-Diwaniya city.
ccounted (20.6%).

Effects of metformin, glyburide and their combination on lipid profile in NIDDM patients

Reyadh H. Hashim

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 67-77

Background and Objectives: DM plays an important role in the endothelial dysfunction and vascular complications like dyslipidemia and atherosclerosis., It is important now a day to evaluate the dyslipidemic effects of oral hypoglycemic drugs in addition to blood glucose lowering effects, since this may provides a better treatment approach and participates in the prevention of complications of DM.
Patients and Methods :We studied the dyslipidemic effects of glyburide, metformin, and their combination on (111) NIDDM patients aged from 39 – 58 years, treated for two years with different treatment lines and compared the results with healthy controls. Serum (TC-C), (TG-C),(HDL-C),(VLDL-C), and (LDL-C) levels were estimated as a marker of dyslipidemia in the serum utilizing lipid profile kit.
Results: Serum TC-C, TG-C, LDL-C, and VLDL-C levels significantly reduced and serum HDL-C levels significantly elevated in patients used metformin alone and glyburide / metformin combination therapy so, maintained serum lipid profiles at levels closer to that of controls, while patients used glyburide as monotherapy significantly increased serum TG-C, TC-C, VLDL-C, and LDL-C levels and significantly decreased serum HDL-C levels in comparison to control group.
Conclusion: Metformin / glyburide combination therapy and metformin monotherapy provide better protection against dyslipidemia associated with NIDDM patients than glyburide used alone, and hence better prevention of complications like atherosclerosis.

Extremities Trauma in Emergency Unit of Al-karama Hospital-Alkut city- Wassit province

Hikmet k. Abbas; Aseel H. Shemal

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 78-85

Extremity wounds compose the burden of injury in Emergency Unit in Al-karama hospital and there is a great need for research to improve the treatment of patient who incur these devastating injuries.
Objective: The aim of this project was to define the epidemiological profile of the patients attended in Emergency Unit in Al-karama hospital regarding the upper and lower limb trauma.
Methods: Authors and trained assistants collected data with aid of a simple
proforma was designed to collect basic demographic data , type of accident,type of injury in general, type of management , site of injury in the body, place of management and the last result of this management, A total number of 189 cases were included in this study. The period of the present study extended from October 1, 2010 to February 1, 2011.
Results: Most cases of this present study were male (67.7%) . The commonest causes of trauma admissions were musculoskeletal injuries to the extremities (41.8%).
RTA are the major cause of extremity trauma (31.7%) . This study shows that trauma of the upper limb is (63.5%) . (52.9% ) of present study were managed in surgical ward. According to faith of the patient,the present study show that (55.5%) had complet healing.
Conclusion: Extremity wounds compose the burden of injury in Emergency Unit in Al-karama hospital.So in conclusion the demands of providing quality affordable emergency surgical services in the setting of a developing country are enormous and will continue to rise . There must be adequate government support as well institutional commitment to the development of its human and structural resources to meet these needs .

The association between acne vulgaris and Tumor Necrosis Factor- alpha gene promoter polymorphism at position-308

Hamadi Hadi Abttan Al-Hilali

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 86-95

Results; genotyping of TNF-α revealed three genotypes; the wild homozygous GG type, the heterozygous GA & the mutant homozygous AA type, the genotype frequency for these three types in acne patients was (29%, 67% & 4%) respectively, in control group, however, it was (58%, 30% & 12%) respectively. The frequency for GA type was found statistically significantly increased in acne patients compared to the healthy controls (P<0.001), significant association was found between the minor A allele and females patients(40.6%) compared to healthy females(28.8%) ,P value 0.001,also all the female that had severe and very severe acne carry the GA genotype.
Background ;This study was carried out on (100) patients (64 females & 36 males) with different severity of acne vulgaris with an age range(11-40 )year, seen in AL-Diwaniya Teaching Hospital/ Department of Dermatology, from December 2011 to February 2012, another (50) apparently healthy subjects were taken as a control group.
Materials; Blood samples were collected from both groups, genomic DNA was extracted from peripheral blood leukocytes for further molecular study, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used .

Emergence of plasmid mediated aac(6´)-Ib-cr Gene in Flouroquinolon- resistant Acinetobacter spp.

Adnan H. Al-Hamadani; Ali M. Al-Mohana; Ali S. Al-Khazaali

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 96-107

This study aimed to detection of plasmid mediated aac(6´)-Ib-cr gene in fluoroquinolon resistant Acinetobacter spp. A total of 154 clinical and inanimated samples were collected from inpatients and medical devices from different units in Al-Dewaniyah Teaching Hospital during a period of five months from November 2011 to March 2012. Sources of specimens were ICU (n= 85), burn unit (n=43) and urine from inpatients suspected with UTI (n=26). Totally, 16(10.3) Acinetobacter spp. were obtained. Identification of Acinetobacter isolates to species level was done by VITEK 2 compact system, results showed that the vast majority of isolates belong to A. calcoaceticus A. baumannii complex (15, 93.8%) while only one isolate (6.3%) was belong to species A. lowffii. All of the 16 Acinetobacter spp. isolates were testwd to susceptibility against 20 antibiotics by VITEK 2 system with GN-AST23 cassettes.
Result showed that all of isolates were resistant to at least three classes of antibiotics.
Isolates showed high resistance rates to first-, second-, third- and fourth generation cephalosporin, aminoglycosides and nitrofurantoin. Results revealed that 11 isolates were fluoroquinolon resistant. DNA of the fluoroquinolon resistant isolates was extracted and used in PCR assay. Results showed that 4(32.3%) isolates were harboring aac(6´)-Ib-cr gene.

Bromocritine Treatment in Infertile Population of Women with Galactorrhea

Taghreed S. Al-Quizwini

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 108-117

Galactorrhoea ( a non-physiological production of milk) can be found with or without raised levels of serum prolactin . Prolactin is the hormone that stimulates milk secretion and cause luteal phase disturbance. Thus galactorrhrea can lead to infertility which is one of the most common gynecological problems of women attending gynecological clinics .All patients included were showing galactorrhea and all were complaining of infertility.The patients were collected from the infertility clinic in the maternity teaching hospital in Al-diwaniah city ,and from private clinics from Oct 2009 to June 2001 and according to strict inclusion criteria, that eliminate other causes of infertility other than presence of galactorrhea and eliminate risky conditions that may exacerbate upon the use of the drug bromocriptine. The total number of patients was 227.
Fasting serum prolactine was examined for each patient and all patients were started on treatment with Bromocripine ( a dopamine agonist ) orally of 1.25 mg or at half tab a day on a fixed dose. The patients were grouped into two groups according to their levels of fasting serum prolactine, group A(G A) had high levels above normal serum prolactine gathering 87 patients and group B(G B) had normal serum prolactine levels gathering 120 patients. Twenty patients were out of the study being either missed from follow up or excluded for risk or for severe side effects. Each patient was followed up for 12 month from the initiation of the treatment or until appearance of response ,which one being earlier.Accumulative pregnancy rates were followed for the two groups in one year following treatment. The result was ( 89.8 % of patients of GA ), and 76.6% of patients of GB ).Although the difference is significant the accumulative pregnancy rate was significant in group B too. Conclusion: In infertile women with galactorrhea, we suggest treatment with bromocriptine in these patients regardless of serum prolactin level.

Post-appendectomy Infected Wounds and Ideal Management A Retrospective Study

Mahmoud M. Al-Mukhtar

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 118-124

Background :Abdominal operations are traditionally classified into elective and emergency procedures both of which may be complicated by postoperative wound infections. Although postoperative wound infection is usually infrequent following elective procedures, it is an anticipated and acceptable complication of emergency surgeries as these operations are usually of a contaminated nature with no standard preoperative preparation associated with an urge to operate.
Objectives :This study tries to compare the results of a two adopted regimes to manage post-appendectomy wound infections in regard to the significance of using parenteral antibiotics.
Methods : This study had evaluated (108) patients with clinical postoperatively wound infections over a period of (3) years in Al-Hilla General Teaching Hospital. All cases with normal appendices and those on preoperative antibiotics therapy for any reason had been excluded from the study. Two treatment regimes had been evaluated : Regime (A) consisting of changing antiseptic wound dressings only while Regime (B) consisted of changing antiseptic wound dressings combined with parenteral administration of intravenous metronidazole (500) mg thrice daily with intravenous cefotaxime (1000) mg twice daily. The study group had been allocated to a randomized single-blind trial to assess the outcomes. Patients were followed–up to an average of (50) days.
Results :There is a beneficial effects of adopting Regime (B) in the management of infected wounds following perforated appendectomies in terms of reducing the number of dressings change and the period of inpatients hospitalization . This was not the case with infected wounds following non-perforated appendectomies.
Conclusion : According to the literature reviewed, in order to prevent or reduce the rate of post-appendectomy infected wounds it is recommended to use preoperative prophylactic antibiotics which is not a routine in our practice.Wound irrigation with antiseptics may be beneficial in prevention of wound infection following complicated appendectomy. Regime (B) of treatment should be reserved for infected wounds following complicated appendectomy.

Effect of montelukast on progression of atherosclerosis

Ahmed M Sultan; Najah R Hadi; Bassim I. Mohammad

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 125-133

Objective: this study was undertaken to evaluate the effect of montelukast on the progression of atherosclerosis.
Materials and methods: A total of 28 local domestic rabbits were assigned into four groups: Group I (normal control), Group II (atherogenic control), Group III (vehicle control),Group IV (montelukast 1.5 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 montelukast don’t have significant effect on lipid profile. Montelukast causes statistically significant reduction in hsCRP and MDA (p<0.05). Montelukast treatment causes significantly increase the level of GSH. Montelukast treatment significantly reduced aortic expression of VCAM-1, MCP-1, and TNF-α (p<0.005). Histopathologic examination of aortic arch showed that montelukast significantly reduced atherosclerotic lesion (p<0.005).
Conclusions: It thus can conclude that montelukast reduces lipid peroxidation, systemic inflammation and aortic expression of inflammatory markers used in this study and hence reduce the progression of atherosclerosis.

The effect of Preeclampsia on some biochemical parameter

Afrah Abdal-Wahed Habib

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 134-140

This survey research to identify the effect of preeclampsia, alterations in renal function, electrolyte and water metabolism are common findings.
To evaluate the usefulness of urine calcium and phosphorus levels as a marker of severity in preeclampsia.
Our study was carried at the Hospital of Maternity and pediatrics in Al-diwanyia city from 1/1-30/6 -2011 .
The total number of all cases 96, among them 20 women with normal pregnancy , 25 cases with hypertension , 20 cases with mild preeclampsia , 31 cases with sever preeclampsia .Every patient was send for urinary calcium and phosphate were determined by the Kramer-Tisdall and phosphomolibidic acid method, respectively.
In the Results There was significant decrease in excretion of calcium and phosphorus in sever preeclampsia[p< 0.001,p< 0.01] respectively as a result of decrease glomerular filtration rate. While in mild cases and pregnancy induced hypertension cases there’s no significant change.
Conclusion: Urine calcium and phosphorus level is significant determinant of severity of preeclampsia and may be considered as usefulness marker for predicting the level of renal impairment.

Epidemiology Of Diarrheal Diseases in Children Below 5 Years in Wassit Province

Aseel H. Shemal

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 141-147

Diarrheal diseases are major causes of morbidity and mortality among children in developing countries. We have analyzed distribution of diarrhea in children under five years of age who resided in rural or urban environments but attended Al_Karama hospital in Al_Kut city in Wassit. In this study we have found that diarrheal disease is more common in family that their parents illiterate, there is a peak incidence at1-2 years old. The disease more in infant who use bottle feeding than in those who feed on breast of their mothers and those with mixed type of feeding.The incidence of the disease is greater in children whose mothers use tap water for feeding. As for the Residence of the parents of these children, the occurrence of the condition is nearly equal between urban and rural regions.There is no significant difference between male and female.
Conclusion: During this study, important environmental risk factors were recognized. Endangered groups and mothers with children under 5 years old should be aware of these risk factors in order to pre¬vent their children's diseases. Prevention of acute diarrhea in children can reduce massive detri-ments to health system.

Identification of bacterial agentsand antimicrobial susceptibility of neonatal sepsis with patient,s outcome

Abdul-Kareem Mohammed Ali; Lamia Abdul-Kareem; Emad Japur Rashed

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 148-161

Background : Sepsis neonataroum is an important factor for morbidity and mortality in neonates. The incidence of neonatal bacterial sepsis depends on geographic area and may vary from country to country as well as within the same country.
Objective: To identify the percentage of neonatal septicemia confirmed by positive blood cultures among 664 neonates admitted in neonatal care unit, and to identify the bacterial agents causing early and late neonatal sepsis and their antimicrobial susceptibility, and the outcome from neonatal septicemia.
Patients and methods: The total number of patients(with clinical signs and symptoms suggesting sepsis) collected from neonatal care unit of AL-Kadimiya Teaching hospital from the 1st of January to the end of october 2011 were 664 neonates, and only 105 neonates who show signs and symptoms suggestive of septicemia that were confirmed by a positive blood culture were enrolled in this study. Data were collected include :Gestational age, Birth weight , Gender, Onset of sepsis, Place of delivery and also we followed up the subjects and recorded the outcome till discharge.
Results: In this prospective study and from 664 neonate were admitted (total number of admission), positive blood cultures were obtained for 105 neonates (15.8%). Gram negative bacteria were the commonest causative agent in both early (66.7%) and late (56.9%) onset sepsis. Among neonates with sepsis, 33 patients (31.4%) had early onset and 72 patient (68.6%) had late-onset neonatal sepsis. The susceptibility of the isolated causative agent to selected antibiotics were the same in early and late onset sepsis. Over 70% of gram negative bacilli were resistant to both ampicillin and cloxacillin but show variable sensitivity to gentamicine and cefotaxime. Most of the isolated gram positive bacteria were sensitive to ampicillin, cloxacillin and cefotaxime but highly resistant to gentamicin. The death rate was 20.9%. Early onset sepsis, male gender, gestational age less than 37 weeks and birth weight less than 2500 gm were found to be significantly associated with death.
Conclusions: Gram negative bacteria were the main cause of early and late-onset neonatal sepsis in our center and many of these isolated bacteria were resistant to the used antibiotics. Low birth weight neonates <2500 gm, gestational age < 37weeks, male gender and early onset sepsis were significantly associated with death. The death rate due to neonatal sepsis was higher compared with the other studies.
Recommendations: Proper antenatal care and optimal obstetric management in early detection and treatment of mothers at risks together with minimizing invasive procedures of infants as much as possible and ideal nursery setup which includes adequate space for care of infants and aseptic equipments for monitoring.

Physiological changes of pneumoperitoneum during laproscopic cholecystectomy

Mohammad O. AL-Muhammadi; Adel Mosa AL-Rekabi; Hamida Salim AL-Mosayi

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 162-175

Background: Recently, the frequency and indication for laparoscopic surgery have increased, and laparoscopic cholecystectomy has been widely accepted as an alternative to laparotomy.To carry out the laparoscopic procedure, a pressure gas, most commonly co2 is used. It is important to know the pathophysiological changes that are caused by an increase in intra-abdominal pressure and by the absorption of co2 from an co2 pneumoperitoneum.
Aim this study; aims to estimate some physiological changes that caused by pneumoperitoneum during laparoscopic cholecystectomy.
Patients and methods: one hundred patients were included in this study randomly selected and consisted of (80 females) and (20 males) their ages were between 19-65 years. Those patients were underwent elective laparoscopic cholecystectomy. we measured some clinical and biochamical parameters (pulmonary function tests, liver function tests, serum urea and creatinine) 24hr before operation as control and 24hr after operation , also we measured end tidal co2(ETCO2),serum aldosterone, potassium and sodium before insufflation of CO2(as control)and at the end of insufflation ,blood pressure and heart rate recorded at different time throughout the operation.
Results: there is a statistically significant changes in haemodynamic responses (systolic, diastolic and heart rate) after pneumoperitoneum and changes in position; Pulmonary function tests (VC, FVC, FEV1, FEV1/FVC) show highly significant decrease (p<0.01) ,highly significant increase (p<0.01) in serum level of ALT and AST enzymes 24hrs post-operative . There was highly significant increase (p<0.01) in ETCO2, serum aldosterone and serum potassium level . Serum sodium, urea and creatinine show no significant changes.
Conclusion: we concluded that laparoscopic cholecystectomy causes notable physiological alteration intraoperatively and postoperatively, caused mainly by pneumoperitoneum and change in position.

The incidence of some virulence factors among thebacterial isolates from the patients with prostatitis and their relation with antibiotic susceptibility

Mohammed A. K. Al-Saadi; Awatif H. Issa; Saad A. Atiyah

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 176-186

Background:Inflammation is observed in theprostate tissue from patients with prostatitis and the bacteria may involving due to their ability to produce virulence factors. Recent studies have suggested that the decrease in the pathogenicity of Escherichia coli is due to acquisitionof resistance to some antibiotics. This study was performed to investigate three virulence factors includingcytotoxic necrotizing factor-1(cnf-1),uropathogenic specific protein (usp) and group II capsule(kpsMTII) in bacterial isolates from the patients with prostatitis and determine their antibiotics susceptibility patterns .
Methods:The drug sensitivity of (11) bacterial isolates including (10)E. coli isolates and (1) Enterobacteraerogenes isolate from patients with prostatitiswere evaluated by using a disc diffusion method. The prevalence ofvirulence genes (cnf-1, uspandkpsMTII ) was determined by PCR.
Results:The isolates were highly sensitive to amikacin (81.81%).But the isolates showed a high resistant to other antibiotics , ampicillin (100%), Co-trimoxazole (100%) , Azithromycin (81.81%) , Cefotaxime (81.81%) , Ciprofloxacin (72.72%) and Gentamicin (63.63%) . PCR showed that kpsMTII (72.72%) was more prevalent than usp(18.18%) and the cnf-1 was not detected in all isolates .
Conclusion: We propose that the isolates from patients with prostatitis were low virulent in combination with high resistance to many antibiotics.

Effect of metformin on pregnancy outcomes in women with PCOS

Asma A. Swadi; Saba M.Swadi

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 187-195

Background: Recurrent pregnancy loss (RPL) classically refers to the occurrence of three or more consecutive losses of clinically recognized pregnancies prior to the 20th week of gestation (ectopic, molar, and biochemical pregnancies are not included). we hypothesized that metformin owing to its metabolic, endocrine effect may reduce the incidence of first trimester miscarriage in PCOS women.
Materials and Methods: We examined the records of all 82 nondiabetic women with the polycystic ovary syndrome who became pregnant while being seen in the out patients Clinic of the maternity teaching hospital and private clinic in AL-Qadisyiah city between January 2011 and march 2014, and who did receive metformin 3 months pre-conception (group1; n = 37) in contrast to second group who became pregnant while taking metformin and continued taking metformin at a dose of 1000–2000 mg daily throughout the first 20 weeks of gestation(group2; n = 45).
Results: both groups were similar with respect to all background characteristics (age, BMI, parity, RBS, blood urea and serum creatinin).rates of early pregnancy loss in group1(82.5%) compared with (79.7%) in group2.after administration of metformin; pregnancy loss was( 83.7%,15.5%) in group1 and group2 respectively (P value = 0.001).
Conclusion: administration of metformin in the first 20 weeks of pregnancy to women with PCOS was associated with a marked and significant reduction in the rate of early pregnancy loss.

Antibacterial susceptibility patterns of Klebsiella pneumoniae isolates from vaginitis cases of pregnant women in Baghdad city

Mohammed Sh. Jebur; Abbas Atyia Hammoudi

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 196-203

A cross sectional study to assess the incidence and the antibacterial susceptibility patterns of Klebsiella pneumoniae isolates in pregnant women who were presented at many hospitals of Obstetrics and Gynecology in Baghdad city during 2012.
A total of 450 vaginal swabs from pregnant women (in first three months of pregnancy) with history of fever, vaginal discharge and other clinical symptoms were investigated , by using different bacterial cultures to identified and diagnose the bacterial isolates.
The frequency of 128 bacterial isolates were diagnosed Staphylococcus epidermidis 50 (39.06%), Escherichia coli 29 (22.6%), Klebsiella pneumoniae19 (14.8%), Streptococcus spp.14 (10.9%), Lactobacillus spp.8 (6.2%), Citrobacter freundii 6 (4.6%), and Serratia spp.2 (1.5%). The antibacterial susceptibility patterns of Klebsiella pneumoniae only Ciprofloxacin showed 100% sensitivity in-vitro. While Clarithromycin, Amoxicillin, Pipracin, Streptomycin, Trimethoprim, Cefotaxime, Azitreonam, Augmentin and Gentamicin showed varied sensitivity / resistance responses. These findings suggest an increasing of resistance to the antibacterial agents that commonly used for vaginitis and the rate at which bacteria become resistant to antibacterial agents are of public health concern. This calls for routine bacteriological culture and sensitivity test in the management of bacterial vaginitis. Further, the provisions of adequate health care that keeping the women vagina healthy and maintain human public health.

Identification of Cryptosporidium Antigens in Stool Specimen Using Enzyme Linked Immunosorbent Assay (ELISA) in Al-Diwanyia Province- Iraq

Ghada Al-Omashi

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 204-213

One hundred fifty six of stool samples were collected from patients suffering form diarrhea; the samples were classified according to the rural and urban areas, gender, age and immune status (pregnancy, diabetes, and corticosteroid therapy).
Routine parasitological examinations were done to all samples using acid-fast stain technique. Antigens detection method was also done by using ELISA.
The acid fast technique results showed that 23 /156 (14.7%) were positive cases for identify Cryptosporidium oocyte in stool specimen, while the ELISA showed 82/156 (52.5%) were positive cases for identify Cryptosporidium antigen in stool specimen.
The rural areas showed higher positive cases(17.5%) than urban areas and males' positive cases were higher results ( 18.7%) than females, while the results showed that lowest positive case were in age group 16-20 years (5.2%) and the highest case were in age group less than 5years (29.4%).
Immune status (pregnancy, diabetes, and corticosteroid therapy) of patient showed an important role in the cases disruptions of the infection with Cryptosporidium spp.(17.6%, 29.8 % 27.6 %) respectively.
The sensitivity, specificity of ELISA for identification Cryptosporidium antigens in stool specimen in comparison with the modified acid-fast staining method were determined 95%, 100% respectively, so it can be concluded that acid-fast technique which can be used as a referential diagnostic method has some limitations while the ELISA is more sensitive and specific for identification of the parasite antigens in stool specimens.

Maternal risk in teenage pregnancies

Anwar N. Al-Bassam

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 214-223

Background: Early marriage and confinement are contributing factors to high maternal mortality and morbidity.
Objective: To identify the maternal complications of teenage pregnancy.
Patients and Methods: A hospital based cohort study was undertaken among pregnant ladies admitted to Baghdad teaching hospital.
The study group comprised of teenage mothers between 15-19 years old and a control group of mothers between 20-24 years old in their first pregnancy. Data included socio-demographic characteristics, ANC, medical and obstetrical complications, mode of delivery .
Results:. The study group include 228 primigravida aged between (15-19)years and the control group composed of 272primigravida aged between (20-24)years.There is statistically significant difference between the two groups in educational level (p=0.0001), antenatal care (p=0.0001) , anemia (p=0.0001), hypertensive disorders [ OR-95%CI=10.96 (4.15-35.51) *], elective cesarean section[ OR-95%CI=2.13(1.2-3.85)*]
Conclusion: The study shows that poor educational level ,poor ANC , medical problems complicating pregnancy ,operative deliveries are higher in teenagers.

Study of The relationship between uric acid level and some lipid profile for heart disease patients in Alnasseriya city

Wesam Rissan Naif

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 224-233

The present study was carried out to evaluate the relationship between uric acid level and some lipid profile for heart disease patients in Alnasseriya city in the sera samples of (75) patients, in addition to control group involving (45) apparently healthy.
The current study included age ,weight , cholesterol, HDL , LDL, triglyceride ,and uric acid concentration. The study clarified no significant differences (p>0.05) in mean age of patients when compared with healthy control and high significant difference of mean weight between two groups (p<0.01).A highly significant elevated(P< 0.01 ) in the mean concentration of cholesterol, LDL and triglyceride in patients when compared with healthy control ,no significant (P> 0.05) in the mean concentration of HDL in both two groups .It also showed a highly significant increased (P<0.01) in the mean concentration of uric acid in heart disease patients when the results compared with the mean concentration of uric acid in healthy control . In the present study showed there was high significant correlation between uric acid and cholesterol, LDL (P<0.01) and significant correlation with triglyceride (P<0.05) but no significant correlation between uric acid and HDL (P>0.05 ).

Sprengel's Deformity Associated with Omovertebral bar between Inferior angle of the scapula and the Cervical spine: A Case Report

Mousa Imran Alghazali

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 234-238

Background; Sprengel's deformity is a rare congenital anomaly of the shoulder girdle. The deformity is due to failure of descent of the scapula in intrauterine life.
Case Presentation;We report a case of unilateral Sprengel's deformity Sprengel's Deformity Associated with omovertebral bar between inferior angle of the scapula and the cervical spine ,absence of rhomboid major and rhomboid minor muscles, weakness of trapezius and serratus anterior in a 10-year-old boy.
Conclusion;Sprengel's deformity can be associated with omovertebral bar between inferior angle of the scapula and the cervical spine with other musculoskeletal abnormalities.

Atimicrobial Bioactive Compound Isolated From Cyanobacterium Nostoc linkia

Ahmed M. Athbi

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 239-247

Bioactive chemical compound A1 was extracted, purified and identified from the algal culture of Nostoc linkia isolated from Basra Rivers in southern Iraq. The identification of the compound by using GC-mass was confronted. Solubility, toxicity, purity and the chemical formula and molecular weight of A1 compound were determined. The antimicrobial bioactivity of the purified compound against the bacterial strains Escherichia coli and Staphylococcus aureus and the dermatophytic fungus Candida albicans was tested by using a disk diffusion agar method. The Minimal Inhibitory Concentration (MIC) was also performed. The compound A1 has shown a broader activity spectrum against all the test organisms.

Hashimoto's thyroiditis: a personal experience

Ahmed Mehdi Al-Hashimi

Al-Qadisiah Medical Journal, Volume 10, Issue 1, Pages 248-252

Background: Hashimoto's thyroiditis is an autoimmune disease of the thyroid gland.Literature show that autoimmune thyroid disorders are important cause of goiter in post-iodization phase. This study was carried out to report on Hashimoto's thyroiditis in Iraq since no epidemiological study tackled this situation.
Methods: A total of 5 cases Hashimoto's thyroiditis were collected from 79 cases of thyroid goiter. Fine needle aspiration cytology was carried out, and all patients were subjected to surgery.Thyroidectomy specimens were evaluated histologically.
Results: All patients were females. Their age was 30 ± 5.2 years. Fine needle aspiration cytology showed 60% were benign lesions and 40% of them were atypical.
Conclusion: Hashimoto's thyroiditis is an important cause of goiter in Iraq. Further efforts needed to improve sensitivity of Fine Needle Aspiration Cytology.