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Objective: To highlight the history, development, and current applications of robotics in surgery. Background: Surgical robotics is a recent technology that holds a significant promise. Robotic surgery is often regarded as the new revolution, and it is one of the most talked about subjects in surgery today. Up to this moment, however, the need to develop and obtain robotic technology has been largely driven by the market. There is no doubt that they will become an important tool in the surgical pyramid, but the extent of their use is still evolving and totally dependent on the standard of development of human being. Methods: A review of the literature was undertaken using internet and medical literatures . Articles describing the history and development of surgical robots were identified as were articles reporting data on applications .Results: Several centers are currently using surgical robots and publishing data. Most of these early studies report that robotic surgery is feasible. There is, however, a paucity of data regarding costs and benefits of robotics versus conventional techniques. Conclusions: Regarding its global use , robotic surgery is still in its infancy. Its current practical uses are mostly confined to smaller percentage of surgical procedures worldwide . Robotic surgery is a new and exciting emerging technology that is taking the surgical profession by storm. Up to this point, however, the race to acquire and incorporate this emerging technology has primarily been driven by the market. In addition, surgical robots have become the entry fee for centers wanting to be known for excellence in minimally invasive surgery despite the current lack of practical applications. Therefore, robotic devices seem to have more of a marketing role than a practical role. Whether or not robotic devices will grow into a more practical role remains to be seen. Our goal in writing this review is to provide an objective evaluation of this technology and to touch on some of the subjects that manufacturers of robots do not readily disclose. In this article we discuss the development and evolution of robotic surgery, review current robotic systems, review the current data, discuss the current role of robotics in surgery, and finally we discuss the possible roles of robotic surgery in the future. It is our hope that by the end of this article the reader will be able to make a more informed imagination bout robotic surgery than before reading.

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Background: Benzhexol hydrochloride ( Trihexyphenidyl ) is a potent anticholinergic agent. Abuse of benzhexol has been noted with increasing frequency in recent years Aim of the study: to determine the conditioning place preference of benzhexol administration in the male rats. Materials and methods: Sixteen male, adult, albino rats were useded in this experiments. The animals were randomly divided into 2 groups, eight rats for each group. Each rat of group 1 was placed in the control compartment and once the rat enter the drug compartment, the animal received N.S. in equal volume to the benzhexol dose,, orally (p.o.), by gastric tube. Each rat of group 2 was placed in the control compartment and once the rat enter the drug compartment, the animal received benzhexol 0.2 mg/kg, p.o., by gastric tube. Previous two steps were repeated twice daily for 10 days. On 11th day, each rat in was placed in the control compartment for 10 minutes and all behaviors of the animals were recorded by video camera. Results and conclusion: In group 2 (benzhexol 0.2 mg/kg), the time which spent in the drug chamber (white and brown color) significantly increased (P<0.05) as compared with the time which spent in the control chamber. This study reported that administration of 0.2 mg/kg of benzhexol, twice daily (pd), for 10 days caused conditioning place preference in the rats.

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Objective : This study was performed to assess Hashimoto’s thyroiditis from clinicopathological aspect and thyroid function. Patients and methods: A prospective study of 175 patients underwent thyroid surgery at the Hilla teaching general Hospitals were undertaken between Jan 2006 till Oct 2009 in order to study the percentages of Hashimoto’s thyroiditis to the total cases which were taken and also to know the correlation between thyroid function and histopathological status in those patients whom diagnosed as hashimotos thyroiditis. Results: Of 175 patients underwent thyroid surgery, 18 cases diagnosed as hashimotos thyroiditis, 10 of them were in a hypothyroidism status and 4 cases in those patients more than 90% of thyroid follicles were destructed suffering from severe hypothyroidism, 3 cases presented with moderate hypothyroidism 70-90% of thyroid follicles were destructed,3 cases with mild hypothyroidism , the thyroid follicles lost about 50-70% of total thyroid follicles, 4 cases subclinical hypothyroidism <50% of follicles were damaged , 2 cases were euthyroid and the last one the histopathological finding was hashotoxicosis and functionally the patient was thyrotoxic. Conclusions In recent years, the incidence of Hashimoto’s thyroiditis is on the rise. Most cases diagnosed as hashimotos thyroiditis were in a hypothyroidism status There are strong correlation between histopathological assessment of the destruction of the thyroid follicles and thyroid status.

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Introduction and objective e: Mean platelet volume (MPV) values in association with both thrombosis and inflammation have become a point of interest in the last few decades, and some studies have reported MPV values significantly higher in patients with stroke. This study aims to determine if there is an association between elevated levels of MPV and the severity of acute ischemic brain stroke. Patients and methods: Fifty acute ischemic stroke patients who were admitted to Merjan Teaching Hospital in Al-Hilla City, Babylon-Iraq; during the period from October 2013 to April 2014 were enrolled in this study. They included 22 males and 28 females, their ages ranged from 50-90 years, with a mean age of 70.52±11.264 years. Those patients were divided into two groups based on modified Rankin Scale (mRS): Group 1 (mRS 0-2), group 2 (mRS≥3). This scale was used to assess the severity of the disease. Blood samples were collected from the patients to measure MPV. Results: The study demonstrated that the patients' group with mRS≥3 were significantly older than the other group regarding the age distribution, and MPV values for them were also significantly higher than the other group. Concerning the gender distribution and clinical history of ischemic heart disease and smoking, there were no significant differences between the two groups of patients. Conclusion: Mean platelet volume is a strong and independent risk factor for acute ischemic stroke and high MPV values could be associated with a severe form of the disease.

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Saliva is composed of a complex mixture of mucins, enzymes, antibodies, electrolytes, and hormones, all of which serve to begin the process of digestion and protect the oral mucosa. Saliva testing is proving to be the most reliable medium for measuring hormone levels. Hormone levels in saliva accurately represent the amount of hormone delivered to receptors in the body, unlike serum, which represents hormone levels that may or may not be delivered to receptors of the body. (30 male and 35 female) serum and saliva samples were collected for young student age (18-22) year. Samples were collected from November 2012 to February 2013 of Tikrit University students. All samples were normal individual who no personal or family history of any diseases. Serum and saliva (Testosterone, Progesterone, Estrogen and Cortisol) were determined by using AccuBind ELISA Microwells. All serum steroid hormones were increased when compared with saliva in male but in female serum steroid hormones were increased rather than saliva except serum testosterone which decreased. Measurements of salivary hormone levels are of clinical importance if they accurately reflect the serum hormone levels or if a constant correlation exists between salivary and serum hormone levels.

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This is a retrospective study of cases of childhood poisoning attending the paediatric emergency unit in Basrah province from January 2010 to January 2011 . One hundred and fifty one cases of children aged 12 years and below, cases due to acute poisoning were analysed, the majority of cases were aged between 1 – 5 years 71.5% , the male to female ratio was 1.3 :1, the most common toxicities occurred by ingestion of kerosene 47.01%, medications35.09%, organophosphrus 9.95% ,House items 5.97%, Co poisoning 1.98%. There were seasonal variations of poisoning events with a high frequency in spring 30.46%, and in summer 29.80%. on admission 85% of patients were complaining from mild to moderate symptoms , and 15% had severe symptoms . no fatalities occur during the study period.

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Non-Hodgkin's lymphomas (NHLs) are hematologic malignancy with the highest prevalence worldwide. They are broadly classified as B-cell or T-cell lymphoma depending on which type of lymphocyte becomes cancerous, B-cell lymphoma is more common than T-cell lymphoma.The EBV infects certain epithelial cells and linked to the development of multiple cancers, including NHL, HL, and nasopharyngeal carcinoma.This study designates to determine the frequency EBV lmp-1 inNHL Iraqipatients, and todetermine the correlation between EBV lmp-1and subtypes of NHL.A 42 FFPE blocks were examined included 32 blocks from NHL patients, and 10 blocks from reactive follicular hyperplasia. Genomic DNA was extracted from these blocks using a specific kit and amplified by polymerase chain reaction (PCR) by using oligonucleotide primers specific for EBV lmp-1 gene .Our result shows EBV lmp-1 was detected in 43.8 % cases of NHL, and in 10.0% cases of reactive follicular hyperplasia with no significant (P>0.0.5) variation between these groups. In addition to that,incidence ofEBV lmp-1 was more frequently detected in high grade. From these results we conclude that EBV lmp-1 plays an important role in NHL development especially in high grade histopathological type.

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Background: Severity of infarction in ST segment elevation MI (STEMI) is clinically important so early determination of infarct size by using non- invasive ,non-coasty imaging modalities is a key to assessing the future risk of patients and instructive for optimization of therapeutic strategies. Aims of the study: 1-To evaluate the efficacy of echocardiographic examination in estimation of extension and severity of infarction in ST segment elevation MI (STEMI) and its relationship with cardiac biomarkers and some heamatological changes.2-To find out the relationship between these biomarkers and post STEMI complications . Materials & Methods: The study lasted from 23th ∕ October/2012 to 28th ∕ May / 2013 in AL-Zahraa teaching hospital in Kerbala city There are 92 (56± 13 years old) patients and 86 (50 ± 12 years old) healthy controls are taken in this study. ECG and echocardiographic study of wall motion abnormality had been done for each one as well as serum cardiac biomarkers as cardiac troponin I (cTRI) , Creatine kinase (CK) and creatine kinase myocardial band (CKMB) also hematological ayalysis (WBC,ESR & platelet count) . The patients are classified into 3 groups (G1,G2 &G3) according to wall motion score index (WMSI): G1 WMSI (>2) MI ; G2 WMSI (1.7-2) and G3 WMSI (<1.7) to estimate the extension of myocardial injury . Results: Cardiac biomarkers study , serum cTRI ; CK and CK-MB showed that there was high significant increment in relation to severity of infarction (p<0.01) assessed by WMSI . Our result revealed that there was strong relationship between both serum cTRI and CK-MB concentration and acute complications developed in ST-elevation MI ,statistically reaching (P<0.01) and (p<0.05) respectively. Hematological showed highly significant (p<0.01) increase in the levels of platelet count according to the severity of infarction (G 1,G2 and G 3) while the total white blood cells (WBC)count and erythrocyte sedimentation rate (ESR) showed significant (p<0.01) increment in group 1 and group 3 only. Conclusion: In patients with STEMI echocardiographic examination of left ventricle wall motion abnormalities and calculate WMSI reveal good estimation of severity and extension of infarction which is assessed by increment of cardiac biomarkers .presence of acute complications as arrhythmias which is associated with increase in serum biomarker concentration give us a clue about adverse prognosis of MI.

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Femoral fractures are common in children between (4) and (12) years of age, and (75%) of the lesions affect the femoral shaft. Treatment of femoral shaft fractures can be achieved either by traction followed by a plaster cast as conservative treatment or by surgical treatment. The objective of this study is to compare the results of treatment for femoral shaft fractures in children between ages of 4-12 years using intramedullary nails (titanium elastic nails, TEN) versus traction and plaster cast. Surgical treatment by TEN provides better clinical results in comparison with conservative treatment by traction and plaster cast.

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Back ground and objectives: Warts are epithelial proliferations on the skin and mucous membrane caused by various types of human papilloma viruses. Wart lesions can decrease spontaneously or increase in number and size according to patient's immune status. Many modalities of treatments have been used but none of them proved to be uniformly effective. Cimetidine has important effects on the immune system and are used as immunomodulator in the treatment of various skin diseases. This study was designed to evaluate the therapeutic effectiveness and immunomodulatory activity of cimetidine among children and adolescents with multiple recalcitrant common warts. Materials and methods: Sixty eight patients (37 female and 31 male, 3-18 years old) diagnosed with multiple recalcitrant common warts were the subject of the study during the period from February 2013 to the end of December 2013. All patients were treated with cimetidine (40mgkgday) in two divided doses for three months duration. Monthly visits were conducted to observe size and number of the warts and side effects of the medication. Serum levels of IL-12, γ-INF, and TNF-α were measured by ELISA technique during each of the three months duration of cimetidine therapy. Results: The therapeutic response to high dose regime of cimetidine among the 62 patients who completed the study revealed that, 48 patients (77.5%) had either significant clinical improvement or complete resolution of their wart lesions after the third month of the study course. While immunological study analysis demonstrated that there was a significant (P=0.05) increment in serum levels of IL-12, TNF-α and γ-IFN after three months regime of cimetidine therapy. Conclusions: Through its immunomodulating activity, cimetidine can be proven to offer a safe and very effective treatment option against multiple recalcitrant common warts in children and adolscents.

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Objective :The aim of this study was to test the hypothesis that there is no difference in salivary metal ion content between subjects with fixed orthodontic appliances and their same-gender sister or brother without any orthodontic appliance. Materials and Methods: Fifty orthodontic patients were included in this study. The first group consisted of 25 patients (14 female, 11 male) with fixed appliances placed in their upper and lower arches. The second group consisted of 25 patients(13 female, 12 male) with a fixed appliance placed only in the upper arch. In order to limit the effects of dietary and hygiene habits on salivary metal ion concentration, a same-gender brother or sister (total of 50 subjects) was selected as a control (25 female, 25 male) who were not undergoing orthodontic treatment. Four samples of stimulated saliva were collected from each patient before insertion of the fixed appliance, 1 month after insertion of the appliance, 2 months after insertion of the appliance and 6 months after insertion of the appliance. The 4 samples of saliva were collected from each control patient at the same time intervals as for the fixed-appliance groups .Approximately 5 ml of saliva was collected from each subject. Saliva samples were analyzed for nickel, chromium, by electrothermal atomic absorption spectrophotometry. The detection limit of the method for sample solutions was 1 ng/ml. Statistical analysis was performed by nonparametric tests (Mann–Whitney U and Wilcoxon W).The Wilcoxon matched pairs signed ranks used to test differences between samples before and after insertion of the orthodontic appliances. A Kruskal Wallis 1-way analysis of variance was used to test differences in nickel and chromium concentration among the 3 test groups. A Kruskal Wallis 1-way analysis of variance (ANOVA) was used to test differences in nickel and chromium concentrations among the 3 test groups. Results: The mean salivary nickel (Ni) content in subjects with and without a fixed orthodontic appliance was 16.8 ± 12.2 ng/ml and 10.3 ± 11.7 ng/ml, respectively. A statistically significant difference (P < 0.041) was found between the two groups. The mean salivary chromium (Cr) ion level recorded was 2.4 ± 1.8 ng/ml in the study group and 2.1 ± 1.6 ng/ml in the control group. The difference, however, was statistically insignificant. Conclusion: Nickel and chromium ion concentrations increased immediately after placement of the appliance in the mouth for all study groups. There were no significant differences in the nickel ,chromium levels released by the three groups of appliances at all study periods.Within the limits of this in vivo study, it can be concluded that the presence of fixed orthodontic appliances leads to an increased concentration of metal ions in salivary secretions

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The carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies and is caused by the compression of the median nerve at the wrist region. The aim of this study was to analyze the results of patients who were operated by using 1.5 cm palmer skin incision. (228) carpal tunnel release operations were performed on (181) patients. These patients were assessed pre and postoperatively using Visual Analog Scale (VAS) and Visual Analog Patient Satisfaction Scale (VAPSS) [1]. The (1.5) cm palmer skin incision technique for carpal tunnel release is a safe and effective surgical procedure. It can be used in the surgical treatment of CTS to achieve better cosmetic results and to reduce the complications of other standard techniques.

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Background:Molluscum contagiosum is skin disease caused by the molluscumcontagiosum virus (MC) usually causing one or multiplesmaller dome shaped umbilicated papules with symptoms that maybe self-resolve. MC virus was once a disease primarily of children, but it has evolved to become a sexually transmitted disease in adults. Objective:To study the epidemiology of ocularMolluscum contagiosum presentation in different age groups of Iraqi patients in Al-Diwaniyah city. Method:This clinical descriptive study was performed in the outpatient department of dermatology and ophthalmologyprivate clinic in Al–Diwaniyah from March 2012 – February 2013. A total of 245 Patients were recruited in this study as they diagnosed as ocular Molluscum contagiosum; both classical and non classical presentation were studied. Results:the results showed that there is high incidence among young patients and this increase was much clear in male than female. The low socioeconomic state has also enhanced the occurrence of this virus . Conclusion: Social risk factor for acquisition of ocular MC, particularly in suburban and low social economic area of Al Diwaniyah cityis significant increased compared to the center of city. Sex and age might also enhance the occurrence of this virus.

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Objective To determine whether resection of detrusor muscle (DM) in the first, apparently complete TURBT is a surrogate marker of resection quality. Patient and method From January 2009 to May 2010, 50 patients with new bladder tumours that were judged to have been completely resected were followed up. Strict exclusion criteria were applied. Prospectively recorded tumour size, tumour multiplicity, DM status, grade and stage of tumour, and findings at first follow-up cystoscopy (at 3 months) and at early re-TURBT were evaluated. Early recurrence (for calculating recurrence rate in the first follow up cystoscope (RR-FFC) was defined as pathologically confirmed tumour on early re-TURBT or recurrence at the first follow-up cystoscopy. Results: Of 50 patients, DM was present in 41 patients (82%). Multivariate analyses revealed that large tumours, high-grade tumours, was independently associated with the presence of DM in the resected specimens. The RR-FFCs when DM was absent and present were 55.5% and 21.9%, respectively. The absence of DM independently predicted a higher RR-FFC. This association was also seen in small and low-grade tumours. Conclusions: DM absence or presence in the first, ap parently complete TURBT specimen appears to be a surrogate marker of resection quality by independently predicting the RR-FFC. So the first follow up cystoscopy in those patients with absent detrusor muscle in the first resection should be done within shorter period .

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In the present study evaluation of the effect of different types of separating medium on the hardness of hot-cure acrylic resin material cured by water path conventional method and microwave curing method .Forty specimens of hot-cure acrylic resin were fabricated in order to provide an standardized dimensions of tested specimens (65mmx50mmx2.5 ±0.03mm) length, width and depth respectively∙ these specimens were invested by either cold mold seal or glycerin separating medium ∙ (40) specimens were used in this study, divided into four main groups according to the type of separating medium and curing technique used (ten specimen for each group);were as follows: Group A: Specimens lining with cold mold seal separating medium (C∙M∙S)(control group) cured by water bath device∙ Group B: Specimens lining with glycerin separating medium (G) cured by water bath device∙ Group C: Specimen lining with cold mold seal separating medium (C∙M∙S) cured by microwave device∙ Group D: Specimens lining with glycerin separating medium (G) cured by microwave device∙ The result of this study indicated a significant difference between groups(p<0.05) in ANOVA test and heat-cure acrylic cured by water bath that lining with glycerin have a high mean value in comparison to another tested groups and heat-cure acrylic cured by microwave that lining with glycerin have a lower mean value in comparison to another tested groups . From this study we can concluded that glycerin is safely separating medium that can be used in dental laboratory because it is less cost and gives good mechanical properties when used with acrylic denture base materials. Also we can conclude that the type of packing or curing method affects the hardness of heat-cure acrylic resin.

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Background: Laparoscopic ovarian drilling has been widely used to induce ovulation in women with polycystic ovarian syndrome. There are factors that affect the outcome of this procedure like age of the patient, duration of infertility, body mass index, hormonal changes and menstrual irregularities. Laparoscopic ovarian drilling may avoid or decrease the need for gonadotrophins or may facilitate their effectiveness. The procedure can be done with less trauma and fewer postoperative adhesions than with traditional surgical procedures. Objective: To evaluate the effectiveness and safety of laparoscopic ovarian drilling for ovulation induction in polycystic ovary patients and to identify which of the mentioned factors help to predict the outcome of the procedure. Patients And Methods: This prospective clinical study included 80 patients with failure of 12 weeks clomiphene citrate treatment for an ovulatory infertility due to (PCOS) who underwent (LOD) in Alhindiya general hospital between January 2008 and September 2011. The effect of various patients' pre-operative characteristics on the ovulation rate after (LOD) was assessed. The success rates were compared between these categories of each factor to identify the predictors of success of laparoscopic ovarian drilling. Results: Women with marked obesity (BMI 35 kg/m2) achieved significantly (P < 0.05) lower ovulation rate (40%) compared with those (61.5%) of moderately overweight (BMI 29–34 kg/m2) women and those (75%) of women with normal and slightly elevated BMI (<29 kg/m2). women with testosterone levels 4.5 nmol/l, the rate was 30 %, which was significantly (P < 0.05) lower than those (57%) of women with moderately elevated testosterone (2.6–4.4 nmol/l). Patients with normal serum testosterone levels (<2.6 nmol/l) showed significantly (P < 0.05) higher success rates (80%) than the other groups Conclusion: Marked obesity, marked hyperandrogenism and/or long duration of infertility in women with (PCOS) seem to predict resistance to (LOD). Ovarian drilling by laparoscopy is safe but should be used on selective scale.

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Objective: The type 1 insulin dependent diabetes mellitus (T1DM) and thyroid dysfunctions are common endocrine disorder and each condition affect the others, The associations between these two conditions are well documented, (T1DM) patients are prone to thyroid disorders for different causes . we aim in this study to evaluate thyroid disorder among children with T1DM . Methods : A hospital based case control study conducted in the clinic of endocrine disorders in Alzahra Teaching Hospital for the period between 1st of May 2012 to 31th of January 2013. Fifty patients with type 1 insulin dependent diabetes mellitus (T1 IDDM) consists of group A. The control group (group B)consist of Fifty healthy children . Serum level of TSH,T3,T4 were measured by using Minividas for both groups . Results: Patients aged 5-11 years, Boys were 27 and girls 23 .The mean age of patients was 7.2±1.53 years. The Mean concentrations of TSH were 4.05 ± 1.98 mlU/L in the patients with type 1 diabetic and this is significantly higher than the control group 2.29±0.87 mlU/L with Statistically significant difference (p <0.008). Whereas mean concentrations of TT3 were 1.82 ± 0.35mlU/L in group A and 2.16±0.43 mlU/L in group B this result is significantly lower than the control group with Statistically significant difference (p <0.01) .while there was no significant difference in TT4 values between the type 1 diabetic patients 103.38±8.4 mlU/L and control group 109.70±6.72 mlU/L with(p=0.15) Conclusion: This study shows Thyroid disorder is common in type 1 diabetic children. Periodic estimation of TSH and a lesser degree TT3 is important for early detection of thyroid disorder in T1DM patients before appearance of any clinical signs of thyroid disease.

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The art of medicine and treating the other human is a complex issue consists of three elements those are (DOCTOERS, PATEINTS ,DISEASE) for long time the physicians use the medics and knife as only tool to treat their patient and forgotten that there was third tool to be used which is communications with patients . Nowadays, informed consent has replaced the old paternalistic notion of “the doctor knows best”, with a more collaborative patient-physician relationship. Objectives: To evaluate the content and comprehensiveness of informed preoperative consent from patient and physician view, Express the important of the patient commitments to giving the pre-operative consent, Find out the effect of patient acknowledgment with pre-operative form on their consent and effect on the operation rates, To measure the level of doctor commitment to explain the preoperative form for their patients and the level of explanation given to them Methods and Data Collection: A descriptive cross sectional study was carried out from first of august to 31 of december of 2012 . The sample 103 patient was extracted from patients, operated by different Obstetricians (working at Karbala Maternity Hospital).We developed two types of questionnaires(one for patients and other for the doctors) The questionnaire consists of several items organized in four parts: 1) The demographic data 2)The obstetric information 3) informed consent knowledge and 4) post interviewing data.Specialist obstetrician explained the purpose of the study to each patient atthe second postoperative day asked for her consent to be included in the study and to complete the questionnaire and to explain the form of consent found in patient file and the suggested informed consent that developed according the guideline of the WHO and universal consensual by different academic associations..The Chi square test was used tocompare the results Differences with a p value <0.05 were considered statistically significant. Results and Discussion:In total, 103 patients operated by different surgeons, volunteered to respond to the questionnaire. Most of them were in 26-35 years age group.About 58.3% % of patient have previous surgery one or more , of them 51% they did not know about the consent form at all . About 92% haven’t read the consent form. 99% of patients have understood the concept of consent just after we read the consent form ,while 100% of them agreed that they understood the consentmore after explanation . 84% of patients agreed that the consent should be changed. Regarding the response of the surgeons in the hospital there is mismatch between their answers and the patient answer about any explanation preoperatively ,43% of surgeons did not see the patient signature on consent form preoperatively , 61.9% not sure that their patient signed by themselves on the consent form 33.3% of surgeons preoperative don’t give any information to the patient most of them state that is not their duty,23.8% 0f surgeons don’t share their patients in decision making, 43% of surgeons face problem with patient and family , 44% of these problems because of communications about 90% of them answer that we can prevent these problem by good informed consent ,53% of surgeons faced a patient who refused to do the operation after the consent only 33% of surgeons attended course about informed consent . Conclusion and recommendations: unfortunately we haven't any protocol or education programs about preoperative informed consent and its follow-up by both surgeons and patients so we recommend to initiate those protocols and programs and more courses to train the doctors and medical staff and administrative staff about those protocols . and to change the consent form to approved one.

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Background: The beta –hCG concentration in a normal intrauterine pregnancy rises in a curvilinear fashion until 41 days of gestation at which time it plateaus at approximately 100 000 IU/L & the mean doubling time for the hormone is from 1.4 to 2.1 days . Aim of study:To determine whether serial quantitative serum hCG levels obtained 48-72 hours apart are reliable predictors of pregnancy outcome. Subjects & Methods:A prospective study was done at Babylon hospital for Maternity & Children & private clinic from the period of April 2010 to September 2011 & involved 50 pregnant women in first 6-8 weeks of gestation presented with vaginal bleeding in current pregnancy or abortion in previous pregnancy .Women more than 6-8 weeks of gestation & those with multiple pregnancies were excluded from the study. The level of B-hCG was estimated by a paired blood samples collected 48-72 hours apart. An automated quantitative measurement of B-hCG in the serum was done by VIDAS instrument using ELFA technique (Enzyme linked Fluorescent ASSAY). Results:A total of 50 pregnant women in first 6-8 weeks of pregnancy were followed up by serial B-hCG 2-3 days apart.11 women out of 50 (22%) terminate as spontaneous abortion; 39 women out of 50(78%) had term pregnancy. Mean age was 26.84 years, mean gravida was 3.08, and mean parity was o.7 .The mean gestational age was 5 weeks +1.3 days.Mean hCG at presentation was 8926.5 miu/ml,& after 2-3 days was 16267.39 miu/ml. 8 women out of 11 (72%) had decline in B-hCG after 2-3 days which is statistically significant (p`0.001). While none of women with term pregnancies showed decline in B-hCG after 2-3 days. 37 out of 39 women (94%) with term pregnancy had increment more than 60% in B-hCG after 2-3 days (statistically significant p less than 0.001). Conclusions: 1. Serial quantitative serum hCG 48-72 hours apart provides useful predictors of pregnancy outcome in the first 6-8 weeks of gestation. 2. A single B hCG reading is not predictive regarding the prognosis of pregnancy compared with double readings.

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Introduction. Renal cysts are a very common condition that can occur at any age from newborn to the elderly. Simple renal cysts are generally diagnosed incidentally on sonography, computed tomography (CT) scans, or intravenous urography performed for urinary tract or other abdominal problems. Patients and Method.During the period of Nov 2011 to Oct 2012, 30 patients (mean age 60 years; range 42–77 years; 17 men and 13 women) with symptomatic, voluminous renal cysts were encountered in this study. The size of the cyst was ranging between 10 - 17 mm (mean 14mm). All patients were studied with ultrasound, excretory urography, and contrast enhanced CT scans. In this series, all cysts were of type I according to the Bosniak classification.Transperitoneal laparoscopic deroofing technique was used. Results.The operation was successfully completed laparoscopically in all cases with no conversion to open surgery. There were no major perioperative complications. Two cases only developed ileus postoperatively and stayed for 3 days, this was due to some colonic adhesions that required more dissection. Hospital stay was 2days (range, 1-3 days). After 12 months period of follow up, clinical improvement (disappearance of symptoms) was observed in 25 patients (84.4%). There were 4 patients who continued had lumber pain post operatively and this could be due to that the patient's symptom already due to backache and not related to the cyst. Only 1 patient had increased hydronephrosis that required percutaneous nephrostomy. Conclusions.Laparoscopic deroofing of large simple renal cysts is an efficacious, safe and less invasive method of treatment and is recommended as a primary treatment for symptomatic simple renal cysts.

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Non-Hodgkin lymphomas (NHLs) are hematologic malignancy with the highest prevalence worldwide. They are broadly classified as B-cell or T-cell lymphoma, depending on which type of lymphocyte becomes cancerous. Chromosomal translocations are the hallmark genetic aberration in NHL with specific translocations often selectively associated with particular NHL subtypes. An important example is the t(14;18( which leads to constitutive activation of the bcl2 oncogene by the enhancers of the immunoglobulin heavy chain locus.One of the main objectives of this study to determine the frequency of bcl2 t(14.18) chromosomal translocation in NHL Iraqi patients and also to determine the correlation of bcl2 translocation with subtypes of NHL. A 46 formalin fixed paraffin embedded blocks were examined included 32 blocks from NHL patients, in addition to 10 blocks from reactive follicular hyperplasia, and 4 tonsils as a control group. Genomic DNA was extractedand amplified by polymerase chain reaction (PCR) by using oligonucleotide specific primers for major breakpoint region (MBR), and minor cluster region (MCR) of the bcl-2 gene on chromosome 18 and conserved JH sequence on chromosome 14. The present result illustrate significantly higher frequency of bcl2 t(14,18) at MBR in NHL and reactive follicular hyperplasia Iraqi patients.We concluded the bcl2t(14,18) chromosomal translocation is a hallmark in NHL Iraqi patients with no association with specific subtype.

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Methods: We report spirometric findings in 108 individuals. All were to complete a short questionnaire and were studied by spirometry. Results: Positive response to questionnaire was noticed in 66.7%; 33.3% had no clinical complain and thus negative response. The positive response was particularly common in males who were smoker or ex-smokers. All patients were studied by spirometry which showed that 70.4% had normal spirometric pattern and 29.6% had obstructive pattern. The patients' mean age was not significantly correlated to the response of questionnaire and in determining the spirometric pattern. On the contrary to the questionnaire response, the correlation between spirometric results and socio-demographic characteristics of patients was not significant. Most importantly, the study had shown no significant association between the spirometric results (obstructive or normal) and the clinical response to questionnaire. Conclusions: Routine office spirometry has to be offered to all individuals elder than 33 years whether they have positive or negative response to questionnaire.

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The aim of this study was detection of the bioactive chemical constituents of sesban leaves extract by a qualitative analysis for each ethanol and methanol extract as used the Ethanol extract as antibacterial . The phytochemical analysis of the methanol and ethanol extracts of leaves of Sesbania sesban revealed the presence of flavonoids, alkaloids, steroids, phenols, carbohydrates and anthraquinones. While, they realed other chemical compound such as, tannins, saponins, terpenoids , amino acids and phytosterols. From the other hand, the ethanol extract of sesban was used as antibacterial against the gram positive bacteria (Streptococcus, Enterococcus faecalis (ATCC 29212), Staphylococcus aureus, (ATCC 25923),) and the gram negative bacteria (Escherichia coli (ATCC 25922), Salmonella typhi (MTCC 733), Proteus vulgaris (MTCC 1771), Pseudomonas aeruginosa (MTCC 424), Klebsiella pneumoniae (ATCC 15380) and was compared with standard drugs such as, gentomaicine and pencillin. The result showed greater inhibition zone in Pseudomonas (18 mm) at 1000mg/ml while, smaller inhibition zone in Streptococcus (10mm) at 500mg/ml.

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Back ground : Infertility is one of the most important and under appreciated reproductive health problems in developing countries. The causes of infertility can be found in about 90% of cases, while about 10% of patients don’t know why they can not conceive .The causes of this case (unexplained infertility) seems to be heterogeneous, with suggested potential causes ranging from disturbances in endocrinological, immunological , genetic and reproductive physiological factors. One of the main causes of unexplained infertility is the reactive oxygen species (ROS). Therefore this study is aimed to estimate and calculate the vitamin E and C level. To carry out this aim, the vitamin E and C level had been estimated in both sera and cervical mucus secretions among healthy fertile women (control) and patients with unexplained infertility. Patients and method: The study groups were attended to Babylon Maternity and Pediatric Hospital and privet clinics. All studied patients are suffering from primary or secondary unexplained infertility types and are diagnosed by gynecologist. The study is carried out on (30) apparently healthy fertile women as a control group, their mean age (30.133±8.011years) and (60) infertile women as patient group , their mean age (29.866 ±7.195 years). Results: Vitamin C levels decrease insignificantly(p>0.05) in serum and cervical mucus secretion(9.944 ± 1.549mg/l and14.233 ±3.458mg/l) in patient group comparing with(10.383±3.655mg/l and(16.447± 4.042mg/l) in control group. Vitamin E levels decrease significantly (p<0.05) in serum and cervical mucus secretion(5.272 ± 1.228mg/l and 4.644 ± 1.343 mg/l) in patient groups comparing with (7.337±3.535 mg/l and 7.023± 0.754 mg/l) in control groups. Conclusion: The present study shows that the vitamins level plays an important role in human fertility. Vitamin E levels is significantly decreased in sera and cervical mucus secretion in patients with unexplained infertility.

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The study was conducted on healthy subjects [control (n=39), male=19, females =20] and asthmatic patients who were treated with inhaled salbutamol [patients (n=41), male=21,females=20] and asthmatic patients who were treated with Montelukast drugs [patients (n=37), male = 19 ,females=18].The samples of patients were obtained from Asthma and Allergy Center in Hilla city. The study was performed at the laboratory of biochemistry department in college of medicine, University of Babylon. Measurements the total antioxidant capacity (TAC) , total protein and Superoxide dismutase (SOD)enzyme activities , also Se, Zn and Cu levels were measured by flame atomic absorption spectrophotometry (FAAS), in sera.The results revealed that highly significant decreasing in the TAC and SOD activity in sera of asthmatic patients (p<0.01) in comparison with that of controls subjects. Serum levels of Zn, Cu, and Se were significantly different (p<0.001 for all) in patients when compared with healthy subjects.

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Aim of the study : The study investigated the effect of material thickness on color parameters of maxillofacial silicon . Materials and methods :sixty samples made of silicone rubber. Samples ( 20 * 10 * 3) mm length , width , thickness, and (20 * 10 * 1.5) mm length, width, and thickness were divided into three groups, white, yellow and pink ( 10 samples a thickness of 3 mm and 10 samples thickness of 1.5 mm in each group) . And then the samples were tested for recording color parameters .Results : There was a significant difference for the three color values at different thicknesses, where the value of * L and a * in the three groups decreased as thickness increased while the b * value rose up with the thickness . Conclusions: The increase in the thickness of the maxillofacial silicon associated with a decrease in the value of L * , a * and a rise in the value of b *.

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Clinical hyperthyroidism is caused by the effects of excess thyroid hormone and can be triggered by different disorders. Hyperthyroidism presents with multiple symptoms that vary according to the age of the patient, duration of illness, magnitude of hormone excess and presence of comorbid conditions. Leptin is mainly synthesized and secreted by adipocyte. In addition to the white adipose tissue it can also be produced by brown adipose tissue, placenta, ovaries, skeletal muscle, stomach, mammary epithelial cells, bone marrow, pituitary and liver. It is a messenger of satiety from the fat cells to the brain, a regulator of insulin and glucose metabolism and plays a role in energy balance and body weight by neuroendocrine mechanisms. This study was performed at the laboratories of Biochemistry Department, College of Medicine, University of Babylon. The collection of samples was conducted during the period from the of June 2013 till September 2013 at Al Hussain teaching hospital in Karblaa, including 48 patients diagnosed as hyperthyroidism with age ranging from 19-55 years. In addition to 30 apparently healthy individuals were taken as a control group. Measurement of serum T3, T4, TSH and leptin were done for all patients and control groups. Serums T3, T4, TSH were done by VIDAS technique with principle of combines a one-step enzyme immunoassay sandwich method with a final fluorescent detection (ELFA), while the serum leptin done by ELISA technique with principle of Enzyme-Linked Immunosorbent Assay. The mean age of patient was (38.25± 7.63) whereas the mean of control group was (36.90 ± 5.67) with no statistical differences. Majority of studied patients was female (75.6%). Body Mass Index (BMI) for patients group was (20.95 ± 3.59), majority (48.7%) were underweight. There were significant statistical differences between the mean of Leptin of patients (5.48± 2.72) ng/ml and the mean of control group (35.59 ± 10.74) ng/ml. Low level of leptin might be the responsible cause of increased appetite in hyperthyroidism patient.

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Streptococcus pneumoniae is one of the main humans pathogens, it is important cause of community-acquired pneumoniae. It causes clinical respiratory signs in lower and upper respiratory tract. S. pneumoniae may also occur in the upper respiratory tract, and can be detected from nasopharyngeal secretions. In this study, we developed a Real-Time PCR specific for direct detection of Streptococcus pneumoniae to be applied from nasopharyngeal secretions in adult patients with respiratory tract infections. The Real-Time PCR Primers were designed from the highly conserved of 16S ribosomal RNA gene of S. pneumoniae. Study results, were show that Real-Time PCR was highly sensitive and specific of up to 98% in detection of S. pneumoniae from nasopharyngeal secretions. Where, the bacteria recorded 34 positive out of 46 specimens (73.9%). The study concluded that the used Real-Time PCR assay was provide a sensitive and reliable means for rapid detection of S. pneumoniae in upper respiratory tract infection and this assay may serve a suitable molecular diagnostic tool for detection of S. pneumoniae from nasopharyngeal secretions.

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Objective: To determine the relationship of serum level changes of IL-6, C-RP with retinopathy in two groups of type 2 diabetic patients (with and without retinopathy) in addition to control groups. Method and material: The study was conducted from December2012 to March 2013. On well controlled thirty five patients of type 2 diabetic retinopathy (group one) (23 male and 12 female) with age range (41-75) years. Thirty patients of diabetes without clinical retinopathy (group two) (15 male and 15 female) with age range from (40-75) years were included in this study; duration of diabetes is more than five years in both groups. Disposable syringes and needles were used for blood collection. Blood samples (5ml) were obtained from diabetic patients and control groups by vein puncture. About one ml of whole blood put in EDTA tube for estimation of HbA1c, the remaining blood samples were allowed to clot at room temperature, and then centrifuged at 3000 Xg for 10 minutes. Sera were transferred carefully and stored at -17ºC until analysis time in suitable serum tubes. Statistical analysis: The results were analyzed using Anova and student`s t–test .Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS version 10). A p value less than or equal to 0.05 was considered statistically significant. Results: The mean sera level of IL-6 was found to be significantly elevated (p< 0.05) in DR as compared with the control group. On the other hand, no significant variations were detected in the levels of the IL-6 in the group of DNR with respect to the control group. C-RP level was found significantly elevated (p< 0.01) in patients with DR when compared with control individual, while there was no significant variation of the serum levels of C-RP in DNR (p = N. S.) and control group. Conclusion:Patients with increase serum levels of IL-6 and C-RP need more intensive ophthalmological examination to detect early retinal changes in aim of providing early management of diabetic retinopathy.

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Background: Benzhexol hydrochloride ( Trihexyphenidyl ) is a potent anticholinergic agent. Abuse of benzhexol has been noted with increasing frequency in recent years By reviewing the relevant literature, no model for benzhexol addiction in rats was found. Aim of the study: to designing a model of induced benzhexol addiction in male rats. Materials and methods: Thirty two male, adult, Albino rats were enrolled in this experiments. The animals were randomly divided into 4 g.oups, eight rats for each group. Each rat of group 1 received normal saline (N.S.) in equal volume to the benzhexol dose, twice daily (b.d.), orally (p.o.) by gastric tube for 10 days. Each rat of group 2,3 and 4 received benzhexol 0.1mg, 0.2mg and 0.4mg respectively, b.d., p.o. by gastric tube for 10 days. On the 11th day, each rat was placed in the open-field chamber for 15 minutes and all behaviors (withdrawal symptoms) of the animals were recorded by video camera. Results and conclusion: Withdrawal symptoms such as rooming, wet dog shakes, head shakes, abdominal constriction, facial fasciculation, ptosis and piloerection significantly increased (P<0.05) in group 3 and 4 as compared with control group and model of benzhexol addiction in male rats can be induced by administration of 0.2 or 0.4 mg/kg of benzhexol, pd, po, for 10 days

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Background: Rhinosinusitis is a common problem that leads to a significant amount of health care expenditure due to direct costs of physician visits and antibiotics as well as indirect costs related to reduced productivity and a decrease in quality of life . Aim: The study evaluated the prevalence and severity of various symptom manifestations of chronic rhinosinusitis as well as to analyze the positive effects of endoscopic sinus surgery on the symptoms and quality of life of patients with chronic rhinosinusitis. Patients and Methods: This is a prospective study done in Al-Sader medical city in Najaf during eighteen months period from 1-1-2012 to 30-6-2013. The patients underwent endoscopic sinus surgery for medically refractory chronic rhinosinusitis and were assessed prospectively regarding the symptoms changes after this surgical intervention. Results: A total of 52 patients underwent endoscopic sinus surgery for chronic rhinosinusitis. The most common symptoms of chronic rhinosinusitis before endoscopic sinus surgery in this study were postnasal drip (94.3%), facial pain (90.4%), purulent rhinorrhoea (90.4%) , nasal blockage (86.5%) and headache (69.3%) . Postoperatively 72.4 % of the patients had subjective improvement in their symptoms with a statistically significant effect in the symptoms of nasal obstruction (88.9% success rate) postnasal drip(85.7%), facial pain(80.8%), and purulent rhinorrhea(78.7%). The p value was <0.05. On the other hand the symptom of headache improved in only 27.8% of the patients complained of it with p value = 0.07 Conclusion: Endoscopic sinus surgery results in significant improvement in the symptoms of patients with chronic rhinosinusitis and it is an effective treatment for those who fail to respond to medical treatment. Recommendations : it is recommended that endoscopic sinus surgery should be done in those patients with symptomatic chronic rhinosinusitis and not responding to full course of medical treatments.

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Out of 349 stool samples, 138 (39.5%) were infected with intestinal parasites. The prevalence rate was 82 (34.4%) for male and 56 (50.1%) for female. The prevalence of intestinal parasites was high in bottle feeding children58(52.2%) compared to children with breast feeding 32(31.4%).The predominantnt intestinal parasite was Entamoeba histolytica(13.2%), followed by Giardia lamblia(8.3%),Hymenolepis nana(7.2%),Entrobus vermicularis(6.0%) and Entamoeba coli(5.2%).

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To detect the nasal carriage rate of Methicillin Resistant S. aureus (MRSA) among healthcare workers (HCWs) in the Intensive Care Units by Chromogenic medium and PCR assay, Out of 63 nasal samples, 30 (47.6%) S. aureus isolates were recovered. Out of the 30 isolates, 17 were methicillin resistant. Nasal carriage rate of MRSA was found to be 56.7% among HCWs. Regarding the prevalence of MRSA in relation to the work type, sex and age group of HCWs, the highest rate (83.3%) was seen in the Utility Worker, (64.7%) in the male and (47%) in age group 20 to 29 years. All MRSA isolates which detected by Chromogenic method and confirmed by PCR assay showed the presence of mecA gene. Also this study demonstrated higher compatible 100% in sensitivity, specificity, PPV and NPV between the two methods. In other side all MRSA isolates from HCWs were multidrug resistant (MDR) and high resistant (100%) to Beta-lactam antibiotics: oxacillin, amoxicillin, methicillin ampicillin, and cefoxitin followed by other antibiotics: erythromycin, ciprofloxacin, tetracycline, gentamycin and clindamycin which showed resistance rates 58.8%, 47%, 35.3%, 23.5% and 17.6%, respectively, but they showed high susceptibility to vancomycin.

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