Volume 10, Issue 2, Autumn 2014, Page 1-220


Lipid Peroxidation, Lipid Profile, Serum Leptin and Glycemic Control in Patients With Ischemic Stroke:Role of Vitamin E Supplementation

Imad Abdul-Jabbar Thanoon; Sarraa Dhiaa Kasim

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 1-12

Aims: To evaluate parameters of glycemic control (fasting serum glucose "FSG", serum insulin level and insulin resistance), serum leptin, malondialdehyde "MDA" and lipid profile (total cholesterol "TC", triglyceride "TG", low density lipoprotein cholesterol LDL-c, high density lipoprotein cholesterol HDL-c, very low density lipoprotein cholesterol VLDL-c and atherogenic index "AI" ) and body mass index (BMI) in patients with ischemic stroke and to test the influence of vitamin E supplementation on these parameters, Methods: This study included 62 ischemic stroke patients and 28 healthy control subjects. Patients were randomly divided into 2 groups: group I (n=33) involved patients with ischemic stroke who assigned to receive conventional therapy and group 2 (n=28) included patients who received conventional therapy with oral supplementation of vitamin E (400 IU/d) for 30 days. Fasting blood samples were initially obtained from all patients within 24-48 hours after the accident (before starting treatment) and from the controls and assay of FSG, serum insulin, leptin, MDA, TC, TG, HDL-c and calculation of insulin resistance, BMI, LDL-c,VLDL-c and AI using especial equation were done. For the patients groups, another fasting blood samples were taken after therapy and assessment of the parameters mentioned above were done, Results: Before therapy, there was a significant differences between patients in group one ( on conventional therapy alone) and the controls with regard FSG, serum leptin, MDA, and AI, while there was a significant difference between patients in group 2 and the controls with regard FSG, serum leptin, MDA.
After therapy, there was a significant increase in HDL-c with significant decrease in serum insulin, leptin , MDA and AI in patients in group one, with significant increase in BMI and significant reduction in serum leptin, MDA, TC, TG, VLDL-c, LDL-c and AI in patients in group 2 compared to pre-therapy stages.
By comparison of the net differences of both groups after therapy, there was a significant reduction in the MDA and TC in patients in group 2 compared to patients in group one, Conclusion: Acute ischemic stroke might be associated with disturbances in some parameters of glycemic controls, lipid profile, elements of oxidative stress and serum leptin. Vitamin E supplementation during the early post ischemic period resulted in reduction in oxidative stress and improving some parameters of lipid profile.

Prevalence of Metallo-β-Lactamaseproducing Pseudomonas aeruginosaisolated from different clinical samples in Baghdad province

Alaa H. Al-Charrakh; Salwa Jaber Al-Awadi; Ahmed Salim Mohammed

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 13-19

Background: Metallo beta lactamase(MBL) producing Pseudomonas aeruginosahave been reported to be an important nosocomialinfections.Pseudomonas aeruginosa is a leading cause of nosocomial infections, giving risetoa wide range of life-threatening conditions. Its intrinsic & acquired resistance to many antimicrobial agents and its ability to developmultidrug resistance imposes a serious therapeutic problem.
Materials and Methods: A total of 75 P.aeruginosaisolates were isolated from different clinical samples in some public & private hospitals in Baghdad city during the period from April to August 2011.Bacterial identification was done using conventional cultural & chemical methods &and VITEk 2 cards for identification (GN), while the minimum inhibitory concentration (MIC) testing was performed using disk diffusion,E-test for Imipenem& Meropenem(oxoid, UK) & (AST-GN30)cards in VITEK 2 automated system(bioMérieux, , France).
Each P.aeruginosa isolates showed resistance to Carbapenems(Imipenem& Meropenem) were subjected to Imipenem-EDTA combined disc synergy test (CDST) to investigate the production of MBL(confirmative test)
Results:Out of 75 P.aeruginosa isolates,16 (21.3%) were grow on MacConkey agar supplemented with Meropenem4mg/L (MMAC),this method used as screening test, The MIC of different antibiotics was performed on these isolates using different methods(VITEK2AST-GN30,Imipenem&Meropenem E-test) showed that 6 (37.5%) isolates were Carbapenem resistant MIC ≥16µg/ml,while 4(25%) pseudomonas isolates appear to be MBL producer usingImipenem-EDTA combined disc synergy test(CDST).
Discussion: MBL mediated carbapenemresistance in P. aeruginosa is a cause for concern in thetherapy of critically ill patients. The MBL producing P. aeruginosa isolates were more resistant to various antimicrobial agents. This result suggests that MBL producing isolates in hospitals may cause serious infections that illustrated when these strains were responsible for a nosocomial outbreak.The findings strongly suggest that there is a need to track the detection of MBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms.
Conclusion: The prevalence of multi-drug resistant P.aeruginosa isolates especially Carbapenem resistant bacteria was increased in Baghdad province.Phenotypic characterization of MBLs provide information about the prevalence of MBLs producing P. aeruginosa in Baghdad.

Factors affecting rate &indications of caeserean section

Ebtihal Abdal karim; afar Alsereah; Ghufran Ja; Sajida Al Rubayeai

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 20-23

A retrospective study of factors affecting rate and indications of primary C/S in Basra maternity and child hospital for period of three years ( 2004, 2005 , 2006 ).Aim: To assess rate of C/S in this hospital ,and the indications of C/S. Methodology: We reviewed the obstetrical files , the data were c collected which included maternal age , parity, fetal weight and indications for C/S at period from the 1st of January 2004 to 31st of December 2006. Result: The rate of primary C /S over the period of three years was 9.16., rate of ( 2004, 2005 , 2006 ) were ( 10.18% , 9.13% , 8.21% ) respectively. Peak of primary C/S is in child bearing age (21 - 25 ) & most common indications were as follow , failure of progress ,CPD , fetal distress and breech presentation. Conclusion: There were vari ations in the rates of primary C/S in Basra maternity and child hospital in comparison with others rates of primary C/S in different hospital in developed & developing countries but there were large similarities in the indications

Prevalence and factors associated with rotavirus infection among infants admitted for diarrhea in the region of Mid Iraq

Wisam S. Abood; S. A. Al-Juboury; M. A. Al-Rodhan

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 24-28

Rotavirus is the most common cause of severe childhood diarrhea worldwide and of diarrheal mortality in developing countries. In Iraq, few studies and analysis were executed for evaluation of the extent of rotavirus caused diarrhea among infants and its magnitude as a cause of the most common clinical attending symptoms to the daily care clinics and hospital admission..
The aim of this study was to estimate the prevalence of rotavirus caused gastroenteritis and identify the clinical factors associated with rotavirus caused diarrhea among infants admitted to the hospital or treated as outpatients in three governorates in the region of Mid-Iraq for symptoms of gastroenteritis.
This study was undertaken during the period from June 2010 to April 2012 in infants under 1 year suffering from acute gastroenteritis. Group A rotaviruses were detected in stools by latex agglutination test and the diagnosis were confirmed by ELISA test.
Of the 348 stool specimens from infants with acute gastroenteritis, 42.45% were positive for rotavirus A. Infants of 9 and 10 months of age were most frequently affected. The prevalence of rotavirus infection peaked in the Autumn season, when temperatures were low, and decreased in summer. There was no significant differences in the severity of symptoms between rotavirus caused diarrhea than and in diarrhea of other causes.
Epidemiological knowledge of rotavirus is critical for the development of effective preventive measures, including vaccines. These data will help to make informed decisions as to whether rotavirus vaccine should be considered for inclusion in Iraqi National Immunization Program.

Brachial artery injury in AL-Diwaniya teaching Hospital

Usama kadhum kredi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 29-36

Aim: to focus on the management of brachial artery injury and it's sequelae .Methods: This is a prospective study of 80 patients admitted at Al-Diwaniya Teaching Hospital from 1st April , 2004 to 30th April, 2007 . All patients were prepared for surgical intervention under general anesthesia and proceed for arterial repair. Results: The most common mechanism of injury was bullet injury (50%) , followed by blunt (27.5%) , stab wounds (16.25%) , iatrogenic factors (5%) and rarely by thermal injury .The technique of repair was by venous graft in the majority of cases (60%) and we needed arteriorraphy in (22.5%) , end to end anastomosis in (15%) and ligation in (2.5%) .Conclusion: Brachial artery injury occurs more in young male group and commonest cause is bullet. Diagnosis of brachial artery injury is done by physical examination. Commonest postoperative complications (late sequelae) due to nerve injuries and joint stiffness.

Study of the hepatoprotective activity of ethanol extract of local propolis in rabbits

Ferdous Abbas Jabir; Noora Khadem Hadi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 37-45

The present study has been conducted to evaluate the hepatoprotective effect of ethanol extract of local propolis at Al-Diwaniyahprovence against CCl4 induce oxidative stress and liver dysfunction in white male rabbits .Twenty four male rabbits were randomly divided in four groups with (6) animal each , the first group was received distilled water (2.5 ml. orally) daily for three weeks then injected with distilled water at( 2.5 ml. subcutaneous) two times at (36) hours interval and considered as control group , the second group was drenched with Ethanol Extract of Propolis (EEP) at dose of (75 mg/kg .BadyWight) daily for three weeks then rabbits were injected with distilled water( 0.25 ml/kg. BadyWight. Subcutaneous) two times at (36) hours interval . The third group was pretreated with Ethanol Extract of Propolis at dose of (75 mg/kg BadyWight. orally) daily for three weeks then were injected with CCl4 at dose of( 0.25 ml/kg Bady Wight .subcutaneous) two times at (36) hour interval , whereas the last group was received distilled water( 2.5 ml.orally) daily for three weeks after that they were injected with CCl4 at dose of (0.25 ml/kg. BadyWight. Subcutaneous) two times at (36) hours interval .At the end of experiment serum samples were collected from rabbits to determine the serum Glutathione (GSH) , then animals were sacrificed where the liver was excised to be examined macroscopically and microscopically.The serum GSH level was significantly (Propapilty≤0.05) decreased after CCl4 injection . A remarkable macroscopic and microscopic pathological alterations were detected after CCl4 administration characterized by necrosis and degeneration of hepatic tissue . Pretreatment with EEP before CCl4 injections significantly reverse the marked decrease of serum GSH also there is improvement in hepatic histoarchitecture. . It was concluded that EEP had the potential antioxidant activities as well as, hepatoprotective efficacy.

Enterobius vermicularis infection among primary school children and its relationship with enuresis in Basrah marshes

Hind Mahdi Jarallah; Kadhmia Waly Mansour

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 46-49

A total of 212 samples (120 female and 92 male) primary school children were examined by used scotch tape methods during the period from February to April 2011 to study the correlation between Enterobius vermicularis infection and enuresis among children, their ages were from 6-12 years in village belong to Basrah marshes. The prevalence E. vermicularis infection of males and females were (72.82%) and (69.16%) respectively, while the prevalence enuresis were (53.73%) and (48.19%) for males and females respectively. Statistically, there are no significant differences (p>0.05) between prevalence of E. vermicularis and enuresis infection for males and females. A total prevalence of pinworm infection and enuresis was 150 (70.75%) and 76 (50.66%) respectively for all children. Statistically, there are no significant differences (p>0.05) between total rate of pinworm infection and enuresis.

Histopathological changes on Splenomegaly induced in Experimental rats Wistar albino

Maha K. Al-Malaak

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 50-62

This study was aimed to evaluate histopathological changes in experimental rats with induced splenomegaly and liver fibrosis by administering thioacetamid (TAA).
Liver fibrosis was clearly noticed in all experimental rats after intraperitoneally injected with a dose (200mg/kg) body weight for 8 weeks ,while control rats injected with buffered saline.The body , spleen and liver weight were recorded , also ratio of liver and spleen per body weight was estimated.Macroscopical changes including (colour, size, congested, signs of fibrosis, irregularity, nature of surface) regarded to liver and spleen were clarified.
The livers showed coarse granulation surface, fibrous (white) spots, pale color and congested with large size, while spleen appeared enlarged, reddish, with fibrous regions, twister and fragil easy to destruct.Biochemical results revealed to statistical difference (p<0.05) in the rate of albumin and total protein concentration in splenomegaly rats compared to control. Inhibition of both (Gpt and Got) enzymes was estimated in rats with splenomegaly up compared to control rats.There was statistical difference in the mean concentration of total bilirubin in splenomegaly rats in comparison to control rats.
The results of microscopic investigation of tissue sections related to rats liver with enlarged spleen showed dilation in portal veins with an increased in (PV) diameter in relation to control rats, also significant increased with splenic lymph nodules diameter in splenomegaly rats compared to control rats.Results on liver sections stained with (PAS) reagent indicated to dense, coarse and red glycogen granules were deposit on hepatocytes also fibrosis, hyperplasia, fibrous septa, large amount of collagen fibers and destruction of normal lobules were observed.The results referred to swollen hepatocytes, pyknotic nuclei, vacuoles with lipid accumulation and moderate steatosis was obvious in all sections of livers with cirrhosis .Hyperplasia, dilated bile ducts and infiltration of inflammatory cells. Spleen sections of splenomegaly rats showed congested red pulp, some lymph nodule s appeared active and more than one aggregated together, thickening in fibrous trabecullae and numerous macrophages with hemosidrin deposite.Hemorrhage with large numbers of erythrocytes and platelets deposit in large blood vessels, thickening in capsule with more fibrous tissue compared with control rats.

Detection of Some SalmonellaEnteritidisVirulence Genes by Multiplex-PCR Assay Using Two Different DNA Extraction Methods

Kareem T. Al-Kaaby; Ahmed H. Al-Dabhaw; Hayder M.Samaka

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 63-70

The aim of this study was screeningsome Salmonella genus-specific virulence genes by multiplex-PCR technique using a group of primers targeting InvA,SipB,SpiA,CdtB,PefA genes using two different DNA extraction methods. A total of fifteen Salmonella isolates from patient's stool samples were collected. Suspected colonies onHiChromeRajhans (HCR) Medium and XLD medium were selected, and biochemical and serological tests were then performed for identification of Salmonella. Identification of Salmonella serotypes was done in Central Public Health Laboratory (CPHL) with O and H antisera. Extraction of bacterial genome was down by boiling method and salting out method using commercial kit (Wizard® Genomic DNA purification Kit). The results showed that all screened genes (chromosomally and plasmid-mediated) were found in all tested SalmonellaEnteritidis strains except cdtB gene which is thought to be limited only to certain SalmonellaTyphi andS.Paratyphi A strains. Moreover,the presence of pefA gene could be depending on host-adapted serovars. Boiling extraction method and commercial kit both gave a good result in multiplex-PCR technique. In conclusion, the results from this study of occurrence of SPIs genes support previous studies suggesting that these virulence genes are widely distributed among Salmonella and required for full Salmonella virulence, in addition, the boiling method was good, easy and specific method for multiplex-PCR technique.

Proline Mesh (Patch And Plug) Repair Of Inguinal Hernia Under General Versus Local Anaesthesia : Early And Long-Term Outcomes

Jawad Kadhim Al-Dhahiry

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 71-77

Background: There is minimal data regarding the feasibility of Proline (patch and plug) inguinal hernia repair under local anaesthesia and patient acceptability.This study compares outcomes of Proline ( patch and plug) inguinal hernia repair under local anaesthesia versus general anaesthsia . Place and Duration of Study: The study was conducted in Department of Surgery,Al-Karama Teaching Hospital,Medical college/Wasit University,Iraq ,from 1st Faruary 2008 to 30th June 2012 and included 124 male patients. Follow-up period ranged from 6 months to 53 months .Study Design: The study design was a prospective study.Methods: This is a prospective study ,included 124 male patients(female patients were not included in this study ) with inguinal hernias that were repaired with Proline (patch and plug) over a 4.5 year period. The outcome (parameters) measures were, the type of anaesthesia used, early and late postoperative complications, and the patient satisfaction. Results: One hundred twenty four inguinal proline mesh hernioplasties were analyzed. Eighty two hernioplasties were performed under local anaesthesia (group A) and fourty two were performed under general anaesthesia (Group B). Patients with a body mass index >30 were 17 (14%) of group A and 8 (6%) of group B, respectively, (p = 0.7). Day cases were higher in the local-anaesthesia group (75 days vs. 16 days, p = 0.001). Early complications were similar in the two groups. 18 (26%) patients in the local anaesthesia and 6 (19%) in the general anaesthesia developed chronic groin pain (p = 0.6). One recurrence was noted in the local anaesthesia group. Patient satisfaction was high with both anaesthetic techniques. Conclusions: Proline (patch and plug) inguinal hernia repair under local anaesthesia resulted in increased day cases with similar complication rate when compared to general anaesthesia. Both anaesthetic techniques were associated with good outcomes and excellent patient satisfaction.

Influence of advanced maternal age on histology of full term human placenta in Basrah

Hassna Bader Jawad

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 78-85

Advanced maternal age defines as age over 35 years at estimated date of delivery .The aims of this research were to determine the impact of maternal age on placental barrier thickness, fetal and placental weight .The study was conducted one total of 25 human full term placentas of multiparous healthy pregnant women obtained from department of Obstetrics and Gynecology unit in Bin Gazwan hospital in Basrah .The examined women were divided into 2 groups ;the control group of consisted of 10 placentas from pregnant women between age of( 20 -34) years and experimental group consisted of 15 placenta from pregnant women of 35years old and older .Stereological and histological study were applied to determine the effect of advanced maternal age on placental barrier and fetal and placental weight . The results showed:
1. Increase in the mean of placental barrier thickness of the placenta of mother >35 years than that of placenta of control group (20-34) .
2. Increase in the main placental weight of mothers >35 years in comparison to that of the control . .
3. Decrease in mean birth weight of mothers > 35 years in comparison to that of
control.
4. Extensive morphological changes in the structural component of terminal villi (capillaries, stroma and trophoblast). The results showed that there is an increase
in the thickness of placental barrier of placenta, decrease in vascularization of the terminal villi and increase in stoma and fibrin deposition in the placenta of
mothers more than 35 years of age in comparison to the control group .

Stereological study of human placental barrier in pregnant women suffering from gestational diabetes

Saleh Mahdi Ali; Sameer H. Abboud; Majid K. Abbas; Saadia S. MehdyZaini; Mohamed T. Naqi; Adnan .H. AL-Hamdani; Naser J. AL-Zawadi; Akeel. A. AL.Kafagi; Nasma. AL.Hujia; Salem R. Hamodi; Hamed D. Habeeb; Mohammed M. Al-Shamsi; Aqeel R. Al-Barqawi; Asaad Habeeb Abdullah; Mohammed K. Al-Jelawi; Iman Abd-Al Wahhab; Sarmad Nory Gany; Hussein Abdul Kadhim; Muhammad O. AL-Muhammadi; Haider M. Ibrahim; Nasser Khalaf Abdulla; Basima Sh. Al Gazali; Maysoon K. A .Al-Hadraawy; Haqi A .A .Al-fatlway; Saleem k.AL- Hadraawy; Salh M. M. Al-Kafagy; Maysoon K. A .Al-Hadraawy; Nasma N Al-Hajjiah; Mohammed M Al-Shamsi; Sabah Al-Zamili; Yahya T. Daoud; Khalid M. Dakhil; Hanaa Daaj Khalaf Al-Mozan; Samira Kgeer Jreemich; Huda Jabbar Dibby; Ibtisam Habeeb; Saeed Al-Azawi; a Abbas Jassem; Ghyda; Noor IdanJarad; Yasamin Hamza Sharif AL-Shibany; Falah Mahdi Ali; Mohammed A. Muhsin; Mohammed Sh. Jebur; Basim M. Hussan; Abdul Hussien M.K. Aljebory; Talib abdulhussien Mussa; Shakir Hamaad M; Raheem Tuama O; Basheer Abd Ali Huoeil; Ali Abed Mhawese; SheimaaAbd Al hamzaBorhan

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 86-93

A prospective case control study conducted at Basrah maternity and child hospital and Basrah medical college. The study includes twenty samples of placental tissue from gestational diabetic pregnant women and ten samples of placental tissue from normal pregnant women ( control group). Tissue sections of all samples were stained by Haematoxylin and eosinand examined under light microscope with screen for stereological investigation to the placental barrier stereological quantitation of placental barrier; comparison between different placental barrier parameters of the placenta in normal and gestational diabetes. Although there is an increase in all means of placental barrier parameters in placenta of gestational diabetes pregnant women than placenta of normal pregnant women but there is no statistical difference at (P<0.05).
There are only exception that (TDD,FBP and MBP are statistically differ at( P

Keywords

The potential effects of short course of Statins on some platelets parameters in rats

Sameer H. Abboud; Majid K. Abbas; Saadia S. MehdyZaini; Mohamed T. Naqi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 94-97

Background : Platelets play an important role in the process of homeostasis, specifically in atherosclerosis formation when low molecular weight lipoprotein deposit in the wall of blood vessels and plaques formation ,this associated with many inflammatory response one of them is Platelet activation subsequent to the adhesion of platelets to the vascular wall results in the release of mediators that promote platelet aggregation. Aim : Statins as most drugs used for treatment hyperlipidemia have multiple effects including anti inflammatory effects , stabilization of plugs and inhibits platelets activation during atherosclerosis of the blood vessels.Materials and Methods : To evaluate the platelets activation there are many simple parameters can be made like platelets count , platelets distribution width, and mean platelets volume. Platelets parameter considered as marker about platelets activation state. Twenty one males rats were enrolled in our research , divided into three group , each group contain seven rats .First group considered as control group , second group considered was given simvastatin , third group was given atorvastatin. The drug dosing continued for 15 days after that blood was withdrawn to measure platelets count , platelets distribution width, and mean platelets volume. Results : There was no significant differences among control and treatment groups in regard to their effects on platelets count , platelets distribution width, and mean platelets volume (P >0.05). Conclusion : Neither simvastatin nor atorvastatin affect platelets count , platelets distribution width, and mean platelets volume.

Key words: Atorvastatin , Simvastatin , Platelets count , Mean platelet volume , Platelet distribution width.

Significant of conventional serological tests in diagnostic of Brucellosis in AL-Diwaniyah province

Adnan .H. AL-Hamdani; Naser J. AL-Zawadi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 98-103

The study was conducted on 351 serum samples from suspected cases brucellosis
of human (125 ) (68 male and 57 female )of age distribution from (10-70) years and
100 sheep (84 females and 16 males) , goat (23 female and 17 male ) and cow (64
female and 22 male ) of different ages (1->3 years) suspected selected from October
2011 to August 2012 in Diwaniyah province. The Rose Bengal test, tube agglutination
test and 2- mercaptoethanol test were used to determine the incidence of brucellosis.
The highest infection rate of disease was recorded by Rose Bengal test 19.2%, 21% ,
17.39% and 8.13% in human sheep ,goat and cow respectively . In human the high
incidence was in male where as in livestock animal the highest incidence was in
females in all serological tests and the highest incidence was in females at the age
between 1-3 years whereas in males more than 3 years of age .The results of tube
agglutination test revealed the titer 1/320 occurred mostly compared with other titers.
Eight chronic cases were determined by 2-mercapto-ethanol test in human and 4 ,1
and 2 chronic cases in sheep , goat and cow respectively. The degree of agreement of
negative samples with Rose Bengal test and tube agglutination, and 2-
mercaptoethanol tests was 99%, 99% in human and 98.43% and 98.43% in sheep, as
well as 100% in both test for goat and cow respectively .

Role of albumin concentration on the level of bilirubin in the neonatal jaundice

Akeel. A. AL.Kafagi; Nasma. AL.Hujia

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 104-106

Jaundice occurs in most newborn infants. Most jaundice is benign, but because of
the potential toxicity of bilirubin, newborn infants must be monitored to identify those
who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin
encephalopathy or kernicterus. Many factors may contributes to this unwanted
outcome amongst this is the concentration of albumin.
The focus of this guideline is to determine the relationship between the level of
serum bilirubin and the concentration of the albumin in neonatal jaundice.
The result revealed no significant changes was observed for the albumin
concentration on the level of bilirubin.

Role of serum erythropoietin level in patients with absolute erythrocytosis

Salem R. Hamodi; Hamed D. Habeeb

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 107-111

PRV is a myeloproliferative disorder with an acquired genetic mutation involving
the stem cell. Erythropoietin (Epo) is a hemopoietic growth factor which provides
some guidance to the diagnosis of PRV.
The study was done to evaluate the diagnostic significance of erythropoietin level
in PRV and its role in pre and post treated PRVpatients.The study includes (47)
patients diagnosed as PRV including (31) males and (16) females with age range (20-
77 years). The criteria for diagnosis of polycythemia is PCV > 52% and/ or Hb ≥18.5
gm/dl for male and PCV >48%and/ or Hb ≥16.5 gm/dl for female.The investigations
which were done for all new patients including CBC, blood films and serum Epo, in
addition to the BM examination for new indicated cases of PRV. Follow up of old
PRV (31) patients were done by PCV and serum Epo. We found thatthe mean Epo
was 9.82mIU/ml. There was no statistical significant correlation between Epo mean
and mean of other parameters.There was a statistical significance between pre and
post treated cases regarding mean PCV and Epo. The acceptible EPO cutoff level to
define PRV of (4.9) with sensitivity (71.4), specificity (86.7) and(p<0.001). So, we
conclude that the serum Epo level was a simple reliable test for diagnosis of PRV with
a cutoff value of (4.9) andthere was a significant difference between treated and
untreated cases of PRV regarding PCV and Epo.

Venomous snakebites in Diwaniah: A Clinicoepidemiological descriptive study

Mohammed M. Al-Shamsi; Aqeel R. Al-Barqawi; Asaad Habeeb Abdullah; Mohammed K. Al-Jelawi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 112-117

Background: venomous snakebite is an important health hazard in this area
associated with high mortality.Objectives: exploration of snake envenomation cases in
children and adolescents up to the age of 16 years in this city with a focus on clinical
and demographic characters and causes of death. Patients and methods: this
observational and retrospective study involves 49 cases of venomous snakebites
admitted to the teaching hospitals in this city between 2005-2009. Results: the median
age of patients was 8 years, 84% of the bites happened during the hot season( May –
August), most cases were from rural areas ( 90%) particularly from Albdeer,
Shannafiah and Alhaffar. The death rate among the studied patients was 28.6% which
was very high in comparison with rates reported elsewhere. Conclusion: There is a
need for exploration of the types of venomous snakes in this area and a demand for
the availability of species specific antivenom.

Assessment of RBCs membrane protective activity of citicoline and eicosapentanoic- decosahexanoic acid in osmotic fragility model

Iman Abd-Al Wahhab; Sarmad Nory Gany; Hussein Abdul Kadhim

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 118-121

Different organic compounds possess a good membranes stabilizing effects that
protect cells like erythrocytes from strains exerted by change in medium osmolarity .
These changes in tonicity could predispose RBCs for hemolysis . This disorder could
be assessed by osmotic fragility test . From those compounds that widen osmotic
fragility test values are citicoline (membrane phospholipids precursor) and
polyunsaturated fatty acids EPA-DHA.
Assessment of these compounds on osmotic fragility test revealed that both of
citicoline and EPA-DHA will protect RBCs from hemolysis for a wider range than
values of the control blank. Although these effects were statistically not significant
on considering statistical correlation test, however, the differences were important on
considering t test for the range of saline concentration between 0.4-0.5 at P<0.05 .
From the overall results, both citicoline and pufa induced a significant change in
statbility of RBCs membrane upon exposure of osmotic effects in the saline
concentration between 0.4-0.5. Further evaluation of citicoline and EPA- DHA effects
may be necessary before recommending the use these compounds in protection
against hemolytic diseases.

Evaluation of antioxidant vitamins (A and C) in patients with pulmonary tuberculosis

Muhammad O. AL-Muhammadi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 122-130

Background: The antioxidant vitamins such as vitamin A and vitamin C functions as the first line antioxidant defense against free oxygen radicals present primarily in the plasma. Examination of antioxidants in patients with tuberculosis may identify deficiencies that predispose to severe oxidant injury. However, our knowledge of the antioxidant profile and its relation to tuberculosis patients is scarce, particularly in developing countries.Aim: This study aims to estimate some vitamins antioxidant ,Vitamin A and C in both male and female patients with pulmonary tuberculosis.Patients and Methods: The present study included 26 patients (14 males and 12 females) affected with pulmonary tuberculosis. Their ages from 29-72 years in male patients and in female patients from 22-65 years. Twenty four healthy controls(12 males and 12 females) their aged from 23 – 67 years in male and in female from 23 - 60 were also included in this study . Study was under taken to evaluate the level of antioxidants like vitamin A and vitamin C in patients with pulmonary tuberculosis.Results: There is a statistically significant changes in vitamins antioxidant in pulmonary tuberculosis patients in compared with healthy control. These results of serum vitamins A and C are significantly ( p < 0.001 ) decrease in both male and female pulmonary tuberculosis patients in comparison with healthy control.Conclusion: The levels of non-enzymic antioxidants such as Vitamin A, and vitamin C in serum were significantly depleted in the pulmonary tuberculosis infected subjects when compared with control. There is a strong association between vitamin A and vitamin C deficiency and malnutrition in these patients , as well as a correlation between several indexes of malnutrition and low concentrations of antioxidants may suggest the involvement of low food intake and nutrient malabsorption in the generation of oxidative stress in pulmonary tuberculosis patients.

Retinal complicatios after Nd:YAG Laser iridotomy

Haider M. Ibrahim; Nasser Khalaf Abdulla

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 131-137

To identify the retinal complication after Nd:YAG laser iridotomy in patients with angle- closure glaucoma (ACG)
Retrospective cross sectional study reviewed the medical records of 177 eyes of 177 patients with ACG with initial intraocular pressure (IOP) above 40 mmHg. All of the patients received maximum tolerable medical therapy (MTMT), followed by laser iridotomy done in 156 eyes and not done in 21 eyes (because of variable causes). In order to follow – up the occurrence of retinal complications all patients underwent detailed retinal examinations.
Retinal complications occur rarly after Nd: YAG laser iridotomy in patients with angle – closure glaucoma (ACG).
Cystoid macular oedema (CMO) occurred in3(1.92%) of 156 eyes
Central serous chorioretinopathy (CSR) occurred in 1(0.64%) of156 eyes.
Macular hole in 1(0.64%) of156 eyes.
Retinal detachment , Uveal Effusion ,Subhyaloid haemorrhage and Retinal burn not seen in the study .
Our data suggest that we can expect retinal complications after laser iridotomy in eyes with AACG (even uncommen), and the incidence increase in females and with advancing age.

Study level of Interleukin-1β and Interleukin-2 in women infected with Trichomonas vaginalis parasite

Basima Sh. Al Gazali; Maysoon K. A .Al-Hadraawy; Haqi A .A .Al-fatlway

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 138-143

The study was conducted on 450 out patients and 30 healthy women, whom have visited the department of infertility at Al-Sadder medical city, Al-Zahra Hospital and in Najaf Province during the period from January till August, 2012. The infection with T.vaginalis in clinical suspected women determine by using the wet amount microscope,the infection women numbers and percent by wet mount microscope gave 49 (10.88%). The results revealed the frothy white discharge 40 (68.96%) while the malodor discharges gave 55 (94.82%) respectively. The results showed significant increased (P<0.01) in concentration of interleukin-1β and interleukin-2in serum of T.vaginalis infection patients in compared to healthy group.

Molecular and immunological study for detection of IL-6 in men infected with Trichomonas vaginalis parasite in Al-Najaf province; Iraq

Saleem k.AL- Hadraawy; Salh M. M. Al-Kafagy; Maysoon K. A .Al-Hadraawy

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 144-148

The aim of this research was to diagnosis of Trichomonas vaginalis by use PCR technique and evaluate interleukin-6 (IL-6) in men infected with Trichomonas vaginalis; urine and blood specimens were collected from 85 men whom have visited the department of infertility at Al-Sadder medical city, Al-Zahra Hospital in Najaf Province during the period from June till October, 2012. Twenty healthy looking age matched men taken to serum tubes and serum was separated. Serum was used for evolution of the IL-6.The IL-6 was evaluated in serum using ELISA technique .Trichomonas vaginalis was isolated from 15 men with a prevalence rate 17.64% by using PCR technique. The results revealed a significant increase in IL-6 in men infected with Trichomonas vaginalis in compared to control group and the PCR is accurate method used in diagnosis of Trichomonas vaginalis parasite.

Students` Self-Assessment in Pediatrics in Al-Qadisiah University School of Medicine

Nasma N Al-Hajjiah; Mohammed M Al-Shamsi; Sabah Al-Zamili

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 149-151

Objective: student self-evaluation is an important component of clinical education and also of a comprehensive clinical evaluation system. Our aim was to determine the reliability in the evaluation system in our college.Methods: The study included 72 final year medical students in the academic year 2010-2011. The students were asked to freely evaluate their selves in the final theory, traditional long case and OSCE in pediatrics by putting a score representing their performance in these exams. The students self-rating was compared with the actual scores these students obtained.
Results: There was a significant correlation between students self-rating and the actual students scores in the final exam in pediatrics.Conclusion: In the presence of a consensus among departments on the level of knowledge and skills that need to be mastered by students during undergraduate medical education, and the implementation of active training program ; students self evaluation could be used as an additional method of students evaluation and assessment.

Study the infection with intestinal parasites (Entamoeba histolytica) and its effect on the blood nature in children from Thi-Qar province

Yahya T. Daoud; Khalid M. Dakhil; Hanaa Daaj Khalaf Al-Mozan

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 152-158

The present study has included collection of 1001 fecal samples of children aged seven years and less than that age . 333 blood samples have been collected for the children that proved their infection by intestinal parasites from samples of study and 100 blood sample from non - infected who visited different hospitals in Thi – Qar Provence during the period from the first of October 2010 to the end of July 2011 to study the rate of intestinal parasites infection and their impact on certain criteria bloody . The fecal samples have been examined by two methods are: direct smear using Normal Saline and Lugol,s Iodine and indirect with flotation by using Zinc Sulfate water ZnSO4. 7H2O . The results have showed that percentage of infected children with parasites was % 33.3 . Entamoeba histolytica formed high percentage % 30 . Significant differences by using (T-test) in level P< 0.05 become clear when studying effect type of infection and type of parasite on some criteria bloody such as Packed Cell Volume PCV , Hemoglobin Hb, White Blood Cell WBC and Number of eosinophile. E. histolytica formed high percentage therefore we decided to highlight on the impact of that parasite in red blood cells and the concentration of antibodies formed against it , but the statistical analysis did not find any significant differences in the criteria for red blood cells between infected and not infected with this parasite, as well as the concentration of IgG while we found IgM concentration difference in patients compared to non-infected.

Isolation of Some Bacteria from Chronic Otitis Media

Samira Kgeer Jreemich

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 159-163

Chronic Otitis media is a very common disease in people of Diwania due to several factors , microbiological , envirnmental and social .
Swab samples and data were collected from private surgeries of specialized doctors ( ENT ) . 75 samples were collected , 51 cases were positive ( 68%) and 24 cases were negative ( 32%). Number and percent of infected males 28 ( 54.9%) , while number and percent of infected females 23 ( 45.1%) .
The main results showed high percents of infection were in ages between 20-29 years old and 30-39 years old( 31.4 % and 25.5% ) respectively .
Six types of bacteria were isolated from the patients , two of them were gram positive ( Staphylococcus aureus and Streptococcus pyogens ) while gram negative were four ( Pseudomonas aeruginosa , Proteus vulgaris , E. coli and Enterobacter cloacae ) .
The highest percent of gram positive was S. aureus 90.5% , and the highest percent of gram negative was P.aeruginosa 56.6% ) .Sensitivity test was done to know the best antibiotic can be used as treatment for otitis media . The most effective antibiotics for most causative agents were cefotaxin , co-trimaxozole , gentamycin , tetracycline.

Blood groupsdistribution & its relationship with bleeding time and clotting time

Huda Jabbar Dibby

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 164-167

The study carried out on 265 of 2nd year MBchB healthy student in the department of physiology ,collage of medicine in Al-Qadisiya university The study achieved from September 2011 to December 2013, including 265 students ,out of which were 169 females & 96 males. With age range (19- 21 years). Determination of blood group was done for all students and then bleeding& clotting time was determined for each student, it was founded that blood group B was more predominant than other groups among the students, and the clotting & bleeding time was more prolonged in those with blood group O as compared with others , also the female was showing to have prolong clotting & bleeding time than male students.

Detection of Extended Spectrum Beta Lactamase (ESBL) in Klebseilla pneumoniae Isolated from Urinary Tract Infections

Ibtisam Habeeb; Saeed Al-Azawi

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 168-173

This study aimed to examine the dissemination of extended spectrum B-lactamase (ESBL) producing isolates of Klebsiella pneumoniae obtained from patients with urinary tract infection who admitted Al-Diwaniya Teaching Hospital from December 2013 to April 2014. A total of 85 urine samples collected, after the first culturing thirty isolates of Klebsiella pneumoniae were obtained. The results of primary screening showed that all isolates were found to be resistance to B-lactamase antibiotics (ampicillin and amoxicillin) at percentage (100%).
All isolates were screened for their antibiotic resistance against 8 antibiotics of different classes using Kirby-Bauer disk diffusion method. The results showed that all isolates were resistance to ceftazidime, ceftriaxone, and cefepime in (100%), while the antibiotics tetracycline and levofloxacin (66.6%) of isolates were resistance. Half of isolates were resistance against ciprofloxacin and tobramycin, all isolates were sensitive to gentamycin in percentage (100%). Present study revealed increase the percentage of ESBL producing Klebsiella pneumoniae 11 isolates (36.7%) in compared with other studies, also the isolates were resistance to third and fourth generation of cephalosporine

Molecular analysis of A2 gene after treated experimental infected ratswith visceral leishmaniasis

a Abbas Jassem; Ghyda; Noor IdanJarad

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 174-182

The present study has been carried out at College of Veterinary Medicine, Al-Qadisiya University, Iraq for diagnosed the visceral leishmaniasis by qPCRreaction and to investigate the effect of treatment with Pentostam ™ (100 mg /ml) on mRNA expression level of A2 gene in bloodand bone marrow samples of female rats using Reverse Transcriptase –Polymerase Chain Reaction .Blood samples were collected from children infected by visceral leishmaniasis, then injected in the peritoneal cavity ofFourtyWistarfemale rats (weighted 250 ± 2 g.) were assigned into two groups; control group(10rats) and treated group (30 rats). After 8-10 days blood samples collected directly from the heart for diagnosis the infection using quantitative Polymerase Chain Reaction , also collected blood and bone marrow samples from control group to detect A2gene expression byReverse Transcriptase –Polymerase Chain Reaction. The second group was treated with pentostam at dose 25 mg / kg for 30 days and divided into four weeks, and in each week collected blood and bone marrow samples to check the effect of treatment on mRNA expression level of A2 gene. In all of the experimental blood samples, all the results were positive when diagnosed byquantitative Polymerase Chain Reaction . Reverse Transcriptase –Polymerase Chain Reaction results which relied on the relative quantification of A2 gene expression normalized by gene expression levels of housekeeping gene (Glyceraldhyde 3-phosphate dehydrogenase(GAPDH)),The relative quantification results detected the fold changes in A2gene levels of blood and bone marrow samples of rats treated with pentostam. The level of A2gene expression of blood samples was in the first week 0.24 fold, in the second week 0.08 fold , in the third week 0.02 fold and in the fourth week 0.006 fold ,all of that was lower than control sample. Whilein bone marrow samples level of A2gene expression was in the second week 0.09 fold , in the third week 0.04 fold and in fourth week 0.03 fold, all of that lower than control sample.
It can be concluded that the pentostam has active effect on virulence factor (A2gene) ,also the parasite remains dormant in bone marrow samples even after treatmentand possiblyreturn to virulencein the case of any immune inhibition .

Efficacy of combined metformin- letrozole in comparison with metformin-laparoscopic ovarian diathermy in ovulation induction and reproductive outcome for women with clomiphene citrate resistant polycystic ovary syndrome

Yasamin Hamza Sharif AL-Shibany

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 183-191

Background and objective: polycystic ovary syndrome(PCOS) is a common cause of infertility and is associated with chronic anovulation and hyperandrogenism.The aim of current study is to compare the effect of combined letrozole-metformine to that of metformin-laparoscopic ovarian drilling (LOD) for ovulation induction in patients with PCOS.Materials and Methods: on the whole 138 ovarian cycles were studied in 60 patients with clomiphene citrate resistant PCOS in AL-Diwaniyah Maternity and Pediatrics Teaching Hospital during the period of June 2112-June 2114.
All patients (n=60) received metformin 500mg /3times per day ,group A(n=30)received letrozole 5mg daily for 5 days repeated for 6 cycles, group B(n=30) underwent LOD and followed for six cycles. Outcome measures were ovulation rates, endometrialthickness, pregnancyrates, live birth rates and miscarriage rate.
Results: ovulation rate was higher in group A than group B(63.33% versus 30.0%),a significant increase in endometrial thickness in group A than group B(9.9mm versus 9.03 mm).Live birth rate was higher in group A 83.33% compared to 33.33% in group B. There were no significant differences regarding miscarriage rates between both groups. No multiple pregnancy or ovarian hyper stimulation syndrome or congenital abnormality among live births were reported.Conclusions: Combinedletrozole-metformin seems to be a suitable second line ovulation inducing alternative to LOD in women with PCOS who do not respondwith clomiphene citrate.

Efficacy of Laparoscopic retroperitoneal deroofing of simple renal cyst in comparison with open surgery

Falah Mahdi Ali

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 192-200

Objective: to evaluate efficacy and safety of laparoscopic retroperitoneal deroofing in comparison with open deroofed cases.
Patients and methods: over period of 3 years , 11 patients with symptomatic simple renal cysts , underwent laparoscopic retroperitoneal deroofing and another 15 patients with same symptoms, underwent open deroofing.
Results: Insignificant difference between both procedures regarding operative time, blood loss, recurrence rate, with better results for laparoscopic retroperitoneal deroofing regarding hospital staying, convalescence period and wound complication.
Conclusion: Laparoscopic retroperitoneal deroofing of simple renal cyst is safe and effective procedure with minimal complication in comparing with open one.

Detection of Epstein–Barr virus and Cytomegalovirus in Iraqi Acute Lymphoblastic Leukemia patients

Mohammed A. Muhsin; Mohammed Sh. Jebur; Basim M. Hussan

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 201-208

Objective : determination the percent of infection of EBV and CMV infections in Iraqi patient infected with ALL .Methods : the study have concentrated to determine the rate of EBV and CMV infections by detecting EBV and CMV antibodies in both the IgM and IgG classes of immunoglobulins by ELISA method and Indirect Immunofluorescence Test ( IIFT) as well as chromogenic in situ hybridization (CISH) for detecting Epstein-Barr virus (EBV) EBER RNA and CMV DNA . Results : from total 50 ALL patients were involved in this study , 50% were having viral infection (22% patients infected with EBV and 28% infected with CMV) this may be referred that in present study the viral causes may be equal to other unknown etiological factors of ALL collectively. anti-EBV Ig G and EBER RNA were detected in( 24%,12) of all ALL patients and anti EBV Ig M was found only in (4%,2) of ALL patients and patients with positive EBV Ig M also were positive for anti EBV Ig G and EBER RNA while anti-CMV IgG and CMV DNA were detected in (28%,14) of all ALL patients involved in the study and only (8%,4) of ALL patients showed positive anti CMV Ig M and patients with positive anti CMV Ig M also were positive for anti CMV Ig G and CMV DNA. Conclusion : The presence of elevated levels of EBV-infected cells or CMV-infected cells within the peripheral blood may be risk factors for developing ALL and the incidence of CMV infection (28%) was slightly greater than the rate of EBV infection (24%) in ALL patients and this may be referred that in present study the viral causes may be equal to other unknown etiological factors of ALL collectively.

Estimation of Ceraluplasmin (CER) and Alpha- 1 Antitrypsin (AAT) levels among hepatitis patients in acute and chronic state

Abdul Hussien M.K. Aljebory; Talib abdulhussien Mussa; Shakir Hamaad M; Raheem Tuama O

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 0-0

Hepatitis Viruses are a common cause of viral hepatitis, it has a wide distribution among peoples, it has more than five common types: Hepatitis A, B, C, D, E. The level of Ceraluplasmin and alpha- 1 antitrypsin differences in acute and chronic hepatitis, it may be normal or mild increased in acute hepatitis while is decreased in chronic hepatitis patients. And the aim of this study to find out the relationship between the frequency of hepatitis and the concentration of immunochemical protein (such as Ceraluplasmin and Alpha -1 antitrypsin) present in patients during the acute and chronic periods of hepatitis infections.
The total number of 36 patients with hepatitis (B) and 30 patients with hepatitis (C) viral infection with an age range (22- 55 years) were enrolled in this study. Patients who had liver cirrhosis was excluded from this study. With a total number of 24 age matched apparently healthy control group was taken to be compared with case studies. Assessment of serum levels of Ceraluplasmin and α-1 Antitrypsin were done by the Single Radial Immunodiffusion Assay to both case study and control group in Babylon public health laboratory from June to September 2007.
The our result shows no significant (N.S) increased in level of up-1 Antitrypsin among acute patient in both types (B and C) While there is a highly significant (H.S.) result for chronic patients also in both types (B and C). Ceraluplasmin level show (N.S.) decreased among acute patient while there decreases ( H.S. ) In both groups of patients (B and C) after compared with a control sample. This result with agreement with many universal results.

Rubber band ligation of hemorrhoids

Basheer Abd Ali Huoeil; Ali Abed Mhawese; SheimaaAbd Al hamzaBorhan

Al-Qadisiah Medical Journal, Volume 10, Issue 2, Pages 215-220

Haemorrhoids constitute a frequent clinical problem. A variety of conservative treatment options have been proposed, the majority of which can be safely performed on an outpatient basis, like the rubber band ligation RBL which is selected in this study . The aim of the study is to prove the possibility and benefit of the procedure as a treatment for the first
In this study we review the management of 100 patient (70 male and 30 female) with different degree of hemorrhoids, and the age range from 20-75 year most of them at 30-50 year old, underwent rubber band ligation(RBL) on outpatient clinic(private clinic) during period of 19 month from December 2006 to jully2008.
90 patient(90%) did well and 10 patient(10%) did not feel better two of them (2%) did open hemorrhoidectomywhile8 patient(8%) kept on conservative measures.
The RBL is reliable and safe outdoor procedure for the first, second and third degree hemorrhoids.