Table of content

Iraqi Academic Scientific Journal

المجلة العراقية للاختصاصات الطبية

ISSN: 16088360
Publisher: The Iraqi Borad for Medical Specialization
Faculty:
Language: English

This journal is Open Access

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Table of content: 2010 volume:9 issue:1

Article
Low Concentrations of Maternal Thyroxin During Early Gestation :A Risk Factor of Breech Presentation

Authors: Nada Salih Amin
Pages: 1-5
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ABSTRACT: BACKGROUND: Approximately 3-5% of all pregnancies at term are with the fetus in the breech presentation in which whatever thier mode of delivery, is a signal for potential fetal handicap Little is known about the etiology; However there are several etiological factors might be related to fetal movement during pregnancy. Maternal hypothyroxinaema early in gestation may have effect on fetal movement during pregnancy through its effect on fetal brain maturation. OBJECTIVE: To evaluate the relation between breech presentation at term and low maternal free thyroxin levels during early gestation in women not suffering from overt thyroid dysfunction. DesignA prospective observational study of pregnant women. METHODS: Analysis refers to 70 women who met the inclusion and exclusion criteria. Main outcome assessment, Fetal presentation (cephalic–breech) at term gestation in relation to maternal thyroid function at 12 weeks of gestation RESULTS: Breech presentation at term delivery was independently related to maternal free thyroxin ( fT4 ) levels <10th cectile at 12 weeks of gestation (OR 4.63, 95% CI 0.8- 22) CONCLUSION: Women with hypothyroxinaemia ( FT level <10th centile) during their early gestation (without overt thyroid dysfunction) are at risk for persistent breech presentation


Article
Risk Factors of Bronchial Ahtma in Children … A Hospital Based Study

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ABSTRACT: BACKGROUND : Asthma is characterized by inflammation of the airways with intermittent bronchospasm. Bronchial asthma is an important cause of morbidity and mortality in childhood. There are many identifiable risk factors contributing to both the expression and persistence of asthma . OBJECTIVE: This study threw a light on some of the risk factors of bronchial asthma in childhood. PATIENTS AND METHODS: This study was performed to determine some of the risk factors of childhood asthma in 62 asthmatic children admitted to Children Welfare Teaching Hospital in Baghdad Medical City in the period from 1st February to 1st July 2007 . The control group was composed of 108 age and sex matched children attending the outpatient clinic with non pulmonary health problems . RESULTS : Forty two ( 67.7%) asthmatic children were males and 20(32.2%) were females with a male to female ratio of 2.1:1 . Fifty two(83.8%) suffered from bronchial asthma before the age of 3 years , While 10(16.2%) acquired the disease after this age . A positive family history of asthma was positive in 31(50%) asthmatic children compared to 9 (8.33%) in the control group , scoring a highly significant association. A positive family history of allergic rhinitis (27.41%) in asthmatic children was more often recorded than in the control group (21.29%) but the difference was not statistically significant . A highly significant association between a positive history of smoking at home environment and childhood bronchial asthma was detected , where it was found positive in 50(80.6%)asthmatic children and in 55(50.9%) controls . A low crowding index ( ≤ 3 persons /room) was recorded in 52 (83.9%)asthmatics compared to 72 (66.6%) controls , Scoring a significant association between low home density and childhood bronchial asthma. CONCLUSION: The present study concludes certain risk factors being associated with asthma namely positive family history of asthma , passive smoking and low crowding index. The study recommends avoidance of smoking at home where a child with a positive history of these risk factors resides .

Keywords

risk factors --- asthma --- children --- cwth


Article
Shigella Gastroenteritis in Children with A Cute Diarrhea in Children Welfare Teaching Hospital

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ABSTRACT: BACKGROUND : Shigellosis is the most common cause of epidemic dysentery and affecting all age groups especially in the first (2) years of life, It is a major cause of childhood mortality and morbidity in developing countries . OBJECTIVE: To study the extent of shigella gastroenteritis among children presented with acute diarrhea. METHODS: Three hundred sixteen patient were included in the study (186 males and 130 females),admitted to the children welfare teaching hospital, medical city complex, Baghdad, suffering from diarrhea and their ages ranged from 2 months-10 years, over a 4 months period (from the first of December 2007 till the end of March 2008), History and physical examination were carried out, general stool examination and stool culture were done by taking fresh stool samples collected from these children and submitted to serial investigations. RESULTS : The study showed that out of 316patients suffering from diarrhea, 22(6.9%) patients with shigella positive, 16(6.2%)had watery diarrhea, 6(10.7%) had bloody diarrhea, 262(82.9%) were less than 2 years. Out of 22patients with shigella positive 12(54.5%) of them were less than 2 years. Most of the patients presented with diarrhea consume unboiled tap water 192 (60.8%), with 8 (36.4%) of them are Shigella species positive. The use of filtration and chlorination of water at home shows no shigella species diarrhea and only 2 (0.7%) Shigella species negative diarrhea. Diarrhea is the presenting symptom followed by fever 20(90.9%), vomiting 14(63.64%), Then abdominal pain 4(18.18%). CONCLUSION: Shigellosis was found to be the third most common cause of infectious bacterial diarrhea following Escherichia coli and campylobacter jejuni and also the third most common cause of bloody diarrhea following entamoeba histolytica and Campylobacter jejuni, and the relationship between water supply and its sterilization with shigella infection is significantly different between people who consume purified and sterilized water than those who did not.


Article
The Role of Addition of Diclofenac Sodium to Imipramine in Treating Children with Nocturnal Enuresis

Authors: Samir Ali Muter
Pages: 16-20
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ABSTRACT: BACKGROUND: Nocturnal enuresis presents a common medical problem all over the world, over many years various therapeutic options have been tried; none was proved to be superior, because the defect occurs at many levels in the urinary tract and its neuronal control. Nowadays prostaglandins have been proved to play a role at renal, bladder, urethral and sympathetic control of urinary system. OBJECTIVE: We evaluated the role of diclofenac sodium when added to the conventional imipramine therapy in treating patients with primary nocturnal enuresis. PATIENTS AND METHOD: 70 children complaining of nocturnal enuresis were enrolled in this study, half of them were given imipramine alone and the other half were given a combination of imipramine and diclofenac sodium at night before retiring to bed, and the number of wet nights per week was recorded on a calendar sheet by the parents over 4 weeks, those who showed more than 50% reduction in the number of wet nights a week were regarded as responders, who were followed after cessation of treatment over another 6 weeks to look for relapse. RESULTS: Of the patients treated with imipramine alone 57.14% (20/35) showed more than 50% decrease in the number of wet nights weekly compared to those treated by imipramine and diclofenac sodium who showed 84.84% (28/33) response rate (> 2.5 SE of difference between responding proportions). The relapse rate after stopping treatment was 60% (12/20) in the first group compared to 32.1% (9/28) which exactly two times the SE of difference between relapsing proportions. CONCLUSION: The addition of diclofenac sodium to imipramine in treating patients with primary nocturnal enuresis might have caused a highly significant higher response rate and a fairly significant lower relapse rate after cessation of treatment.


Article
Long Term Complications of Type 1 Diabetes Mellitus in Children and Young Adults

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ABSTRACT: BACKGROUND: Diabetes mellitus is a common chronic metabolic syndrome characterized by impaired metabolism of glucose; morbidity and mortality come from acute metabolic derangement and from long term complications that affect small and large vessels. OBJECTIVE: The assessment of the long term complications of diabetes mellitus in children and young adults PATIENTS AND METHODS: The study included 150 patients with type1 diabetes mellitus attending the diabetic clinic of Children Welfare Teaching Hospital who were assessed for the presence of long term complications of diabetes mellitus. RESULTS: The total number of the sample was 150 patients with male to female ratio of 1:1.2 with median age of 12.2 years. Long term complications occurred in 26.7% of patients; (75%) of them had diabetes for more than 5 years. These complications include eye complications (retinopathy and cataract) 12.6%, Renal complications (albuminuria, oedema, and hypertension) 10.6%, peripheral neuropathy 4.6%, limited joint mobility 6.6%, and short stature 17.3%. CONCLUSION: Long term complications were found in significant number of patients with type I diabetes mellitus which can occur in children with short duration of diabetes, and their frequency increases significantly with increasing duration of diabetes.


Article
Predictability of Conversion From Laparoscopic to Open Cholecystectomy: Retrospective Analysis of Risk Factors

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ABSTRACT: BACKGROUND: Laparoscopic Cholecystectomy (LC) is the gold standard operation for cholelithiasis; however, conversion to "Open Cholecystectomy (OC)" is still required in some patients. OBJECTIVE: Is to assess the predictability of conversion by recognition of probable risk factors, a fact that would be beneficial for patient selection and planning of laparoscopic procedures. PATIENTS AND METHODS: Retrospective analysis of data concerning 1350 cases of LC in the last 8 years from 2001 to 2008. RESULT: A total of 28 patients required conversion (overall conversion rate of 2.1%). Preoperative clinical, laboratory and radiological data were evaluated with regard to conversion. Six factors; male gender, age above 45 years, presentation as acute cholecystitis(ACs) , history of repeated attacks of ACs, ultrsonographic gall bladder wall thickness of more than 3 mm. and previous history of upper abdominal operation; showed a statistically significant effect on conversion. Three other factors; raised white Blood Cell (WBC) count, Common Bile Duct (CBD) stone(s) and experience of the surgeon; failed to reach significance. On the basis of Univariate analysis results, all significant predictors were allocated a score, which indicate risk score for conversion. Increasing score was associated with a significantly increased probability of conversion. The optimal cutoff score was 2 with a conversion rate of 3.05 %. Conversion rate was 20% with a score of 8. CONCLUSION: Risk of conversion is predictable on basis of this scoring. Patients predicted to have high risk of conversion may be informed and scheduled appropriately

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Article
How to Decrease the Prevalence of Hepatitis C in Iraqi Hemodialysis Patients

Authors: Omar Salem Khattab
Pages: 31-35
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ABSTRACT: BACKGROUND : Hepatitis C virus infection has been recognized as an emerging problem in dialysis patients, its prevalence varies considerably among different areas of the world. The prevalence of HCV infection in hemodialysis patients and its associated risk factors is not well documented in our country. We performed this study aiming to discuss prevention of further transmission of HCV infection among our patients. OBJECTIVE: We performed this study aiming to discuss prevention of further transmission of HCV infection among our patients. PATIENTS AND METHODS: A cross sectional study done between September 2003 – December 2008 in the Renal Transplant Center, Medical City Teaching Hospital, Baghdad. Including 244 patients with end stage renal failure and had been on hemodialysis for more than 3 months. focusing on the prevalence of anti-HCV positive patients, and the associated risk factors. RESULTS: 153(62.7%) were males, and 91(37.3%) were females, with age range 14-67 years. The prevalence of anti-HCV positive patients was 12(4.9%), dialysis in different centers, female sex, ≥ 60 years age, ≤ 6 months on dialysis, blood transfusion, and < 9 hours per week haemodialysis were significant predictors of anti-HCV positivity. CONCLUSION: We conclude that adherence to universal infection precautions; HCV screening of transfusions and of patients on hemodialysis; and the use of separate machines in separate rooms for those who are anti-HCV positive, was important factors, To further reduce the prevalence in our patients, erythropoietin should replace blood transfusions, also to test for HCV RNA using polymerase chain reaction before starting hemodialysis.


Article
Gastric Cancer Staging Comparism and Role of EUS

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ABSTRACT: BACKGROUND: The tumor stage of gastric cancer in the preoperative period must be evaluated to choose the type of therapy so the preoperative imaging diagnosis is the basis for a tumor–stage –adapted therapy of each patient . OBJECTIVE: Is to compare between the preoperative staging of gastric cancer which includes the ultrasound scan, CT scan and EUS findings and the postoperative staging which include the histopathological finding and to assess the efficacy of EUS in determining the tumor and lymph node stage of tumor. PATIENT AND METHODS: Prospective study of 32 patients with gastric cancer admitted to the surgical word in the gastroenterology and hepatology teaching hospital, medical city, Baghdad over the period from Nov. 2005 to Nov. 2007 who underwent gastric resection , all the cases were proved to be gastric cancer by endoscopic biopsy or by histopathological examination of the gastric specimen after operative resection, and all the cases radiologically investigated in the preoperative period by abdominal ultrasound, endoluminal ultrasound and abdominal CT scan. RESULTS: Show that there is increase in the staging in 18 (56.25%) cases and same staging in 8 (25%) cases and decrease staging in 6 (18.75%)cases. CONCLUSION: Endoluminal ultrasound is most accurate preoperative investigation to determine staging of gastric malignancy. Ultrasound and CT scan although it is important in the assessment but they downstage the tumor in about half of cases. So we recommend that EUS is done for all patients with gastric cancer for accurate planning for surgery


Article
Role of Anticholinergic Drugs in Patients with Benign Prostatic Hyperplasia Symptoms

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ABSTRACT: BACKGROUND: We determined the efficacy and safety of combination therapy of α-blockers and anticholenergic drugs in patients with benign prostatic hyperplasia complain mainly of storage symptoms. OBJECTIVE: Study has been design to assess the efficacy and safety of combined treatment with oxybutynin plus tamsulosin in patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Prospective randomized controlled study of patients with moderate to severe lower urinary tract symptoms. Eligible patients were men 40 years and older with a total IPSS of 12 or higher; An IPSS quality-of-life (QOL) item score of 3 or higher. Additional inclusion criteria were micturition frequency (≥8 micturitions per 24 hours) and urgency (micturitions with urgency rating>3 per 24 hours) for 3 or more months. Men with clinically significant bladder outlet obstruction, or serum prostate-specific antigen of more than 4 ng/mL with risk of prostate cancer were excluded. RESULTS: A total of 24(80%) patients receiving oxybutynin plus tamsulosin (Group3) reported treatment benefit by week 12 compared with 13(46.4%) patients receiving placebo (Group1) (P=0.02), 16 (53.4%) patients receiving tamsulosin(Group2) (P=0.45 vs. placebo), there is statistically significant difference between group 3 and group 2 with the p value 0.04. Patients receiving oxybutynin plus tamsulosin compared with placebo experienced significant reductions in urgency urinary incontinence, Urgency episodes, micturitions per 24 hours, and micturitions per night. Group3 Patients demonstrated significant improvements on the total International Prostate Symptom Score (−7.22 vs. −3.46 in G1, P=.003) and QOL item (−2.21 vs −1.17, In G1 P=.003). The incidence of acute urinary retention requiring catheterization was low in group3, the incidence was only 1 patient 3.3%; 3 patients(10.3%) in group1, while in tamsulosin group there was no patient complain of acute urinary retention 0% . CONCLUSION: These results suggest that treatment with oxybutynin plus tamsulosin provides benefit for men with moderate to severe LUTS and BPH.

Keywords

Anticholinergic --- symptoms --- (BPH) --- bladder.


Article
Evaluation of Triple Assessment Modalities in the Management of Palpable Breast Lumps

Authors: Khalid Nimat Saleem
Pages: 48-56
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BACKGROUND: Breast masses are common clinical presentation in breast clinics, their managements require an efficient and accurate evaluation, using the least invasive, most accurate methods that cause minimal patients discomfort and limit any unnecessary procedure. OBJECTIVE: This study is designed to evaluate the diagnostic accuracy of triple assessment (a combination of clinical examination, imaging studies and tissue sampling) in the preoperative assessment and optimal management of palpable breast masses. PATIENTS AND METHODS: This clinical prospective study which was conducted in mosul breast center, department of surgery, al-jamhoory teaching hospital, mosul medical city, from november 2007 to november 2008 included 60 female patients with palpable breast masses, their age ranging between (20-76) years, were assessed prospectively using triple assessment modalities and the results of each modality were classified as benign, suspicious or malignant and compared with the confirmatory histopathological examination of the tissue specimens obtained from all patients under study via an appropriate surgical procedure. the data was collected, classified and analyzed. RESULTS: The results triple test (TT) was concordant (elements had either all benign or all malignant) in 31 cases (52٪) with diagnostic accuracy reaching (100٪). Again the TT achieved (100٪) diagnostic accuracy when all elements were either malignant or suspicious which appeared in 12 of 29 nonconcordant cases (20٪ of all cases). FNAC was the most reliable element of TT in cases where the elements of TT weren't concordant (NPV 94.5٪, sensitivity 92٪ and accuracy 96.7٪). CONCLUSION: The TT has proved to be accurate, reliable diagnostic approach for evaluation of breast masses, achieved (100٪) accuracy rate when all elements were concordant or when all elements were either suspicious or malignant, with the end result was neither missed cancer nor false positive malignant diagnosis, as the error or limitation of one modality was compensated by the other elements. Any positive result of fnac should be taken seriously with negative results not exclude malignancy while the negative or positive results of imaging studies and examination not necessarily reflect the actual pathology should be supported by tissue diagnosis. Patients in whom the TT elements were all benign can be safely observed, while patients in whom all the elements were malignant or suspicious, the diagnosis was certain enough to proceed with definite treatment without delay.


Article
A Morphological Classification of Ventrical Septal Defects

Authors: Zayir H. Khalid --- Sadiq M. Al Hammash
Pages: 57-61
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ABSTRACT: BACKGROUND: The ventricular septal defects are the most common cnongenital heart disease, Ventricular septum composed of two parts:the memberanous septum is relatively small very thin stracture and themuscular septum ,Which is divided into three regions ; inlet ; trabecular and outlet portion. OBJECTIVE: To find out morphological classification of ventricular septal defects in Iraqi population. PATIENT AND METHOD : Two hundred isolated ventricular septal defect in 196 patients, were identified by two dimension echocardiography and Doppler color flow mapping. Age, Sex of patients and family history were studied. Cross section scan was obtained using a SSH-140A Toshiba machine. RESULTS: Ventricular septal defects were perimemberanous in 70%,inlet in 18%, Trabecular in9%, and outlet in 3%. Lage defects were identified in 21%, and eisenmengers cpmplex in 5%. CONCLUSION: Delay in referreal of patient with ventricular septal defects to our hospital usually resulted in delay institusion of appropriate management and increase risk of future surgery

Keywords

ventricular --- septal --- defect --- aortic --- prolapse


Article
Frequency of Genodermatoses Among Iraqi Patients

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ABSTRACT: BACKGROUND: Genodermatoses are hereditary skin disorders or anomalies which can be grouped into three categories: chromosomal, single gene and multifactorial. Most genodermatoses show single gene or Mendelian inheritance (autosomal dominant, autosomal recessive or X-linked recessive genes). OBJECTIVE: To asses the frequency of genodermatoses among Iraqi patients in outpatients Dermatology and Venereology comparison with other countries. PATIENTS AND METHODS: This case series descriptive epidemiological study included eighty three patients (57males and 26 females) with genodermatoses. They consulted the out patient clinic/ Department of Dermatology and Venereology Baghdad Teaching Hospital from April 2005 through April 2006. Their ages ranged from 2months-60 years (Median 10 years),With various genetic diseases. Full history, dermatological and clinical examinations were done to establish the clinical diagnosis of genodermatoses regarding all demographic points related to these disorders. RESULTS: The frequency of genodermatoses among outpatient attendant in Dermatology and Venereology Department was 83/ 20000 (0.42%). This study had shown that the most common genodermatoses were; ichthyosis: 21 (25.3 %) patients and epidermolysis bullosa which contain 16 (19.3 %) patients when taken together they constituted 37 (44.6%) patients of the total, neurofibromatosis 8 (9.6 %), hereditary palmoplantar keratoderma 6 (7.2%), darier's disease 5 (6 %) and xeroderma pigmentosa 4 (4.8 %). Positive family history of the same disease was obtained in; 8 (38.1 %) patients with ichthyosis, 4 (66.6 %) in hereditary palmoplantar keratoderma, 2 (12.5 %) in epidermolysis bullosa and all patients with Hailey-Hailey disease had positive family history of the same condition. Consanguinity was positive in; 13 (61.9 %) patients of ichthyosis, 12 (75 %) epidermolysis bullosa, 2 (33.3 %) hereditary palmoplantar keratoderma and (100 %) patients with xeroderma pigmentosa CONCLUSION: Genodermatoses are frequently encountered among Iraqi dermatological outpatients and more common in families with positive consanguinity and were comparable to other countries


Article
Across-Sectional Study of Brucellosis in Patients Admitted to Baquba to General Hospital

Authors: Brucellosis, Iraq
Pages: 68-73
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ABSTRACT: BACKGROUND: BrucellosisIs a very common disease in Iraq the manifestations of the disease are different from one persom to the other in which the clinical diagnosis needs a thorugh study and documented precise investigations OBJECTIVE: To describe selected possible for acquiring brucellosis in Diala governorate and compare the relative frequency of selected clinical features between pediatric and adult age groups. PATIENTS AND METHODS: A cross sectional study was done on a sample of 108 patients with an established diagnosis of Brucellosis admitted to Baquba General Hospital during the period extending from May 2001 to June 2003. RESULTS: Males constituted about two thirds of the study sample (65.7%) About a fifty (20.4%) of the study sample were in the pediatric age group (<16 years of age). Raw milk or unpasteurized cheese and raw liver was among the risky for acquiring the infection reported by 67% and 58% of the study sample respectively. Animal contact (Agricultural activities) was reported by 59.3%. Among pediatric age group, the most frequent clinical features were: Spinal tenderness, abdominal pain, arthralgia, sweating aches lack of energy and arthritis. While among adults: Arthralgia, headache, aches, sweating, lack of energy, spinal tenderness, chills, fever, loss of appetite and arthritis were among the most frequently reported symptoms. Hepatosplenomegally is rarely reported and epididymoorchitis is a frequent complication of brucellosis in children CONCLUSION: This result showed a male preponderanc in comparison to female Patients and this probably due to occupational exposure

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Article
Helicobacter Pylori Infection in Patients with Hematological Diseases

Authors: Najlaa Badir Al-Awadi
Pages: 74-79
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ABSTRACT: BACKGROUND: Helicobacter pylori (H. pylori) is a well known bacterial pathogen implicated in gastric diseases. Some studies refer to it's possible role in some hematological diseases. OBJECTIVE: The aim of this study is to determine the association between Helicobacter pylori infection and some hematological diseases. MATERIALS AND METHODS: This is a case-control study of 337 patients with a hematological disease (including acute and chronic leukaemias, Hodgkin's and non Hodgkin's lymphomas, hairy cell leukaemia, multiple myeloma, immune thrombocytopenic purpura and aplastic anemia) who were admitted to or attended hematology center at Marjan Teaching Hospital – Babylon – Iraq during the period from 1/7/2006 to 1/1/2009. Age and sex matched control group of 337 patients who have no hematological disease. They were taken during the same period and from the same geographical area (Babylon governorate).Tests for H. pylori were done for both groups using One Step H. pylori Test Device with 93.7% total accuracy rate. RESULTS: H. pylori test was positive in 33.5% (113/337) and 37.3% (126/337) of control and patient groups respectively, while dyspeptic symptoms were found in 18.1% (61/337) and 39.4% (133/337) of control and patient groups respectively. CONCLUSION: There was no significant association between H. pylori infection and hematological diseases tested in this study in Iraqi patients from Babylon, however dyspeptic symptoms were more common in patients on steroids or chemotherapy


Article
Prevalence of Fibromyalgia Syndrome in Patients with Haemophilia A

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ABSTRACT: BACKGROUND: Fibromyalgia syndrome is a common rheumatological syndrome with multiple systemic manifestations which could occur alone or associated with many diseases. OBJECTIVE: To detect the possible relation between fibromyalgia and haemophilia-A patients. PATIENTS AND METHODS: One hundred patients with haemophilia-a were studied and compared with another hundred, healthy individuals matched for age and sex, serving as control group. Full history was taken and complete clinical examination was done for all individuals in both groups. The american college of rheumatology 1990 criteria for fibromyalgia were applied for both groups. They were questioned about presence of chronic widespread pain, sleep disturbance, headache fatigue and parasthesia . Detection of at least 11 of 18 tender points by digital palpation of specific soft tissue sites were needed for diagnosis of fibromyalgia. RESULTS: There was a significant increase in the frequency of fibromyalgia among individuals with haemophilia-a (25%) compared to healthy control group (3%) (p=0.000004, odd ratio=0.093, 95% confidence interval 0.027-0.319). CONCLUSION: Fibromyalgia occurs with high frequency in hemophilia A patients


Article
Evaluation of Serum Electrolytes and Uric Acid in Iraqi Epileptic Patients

Authors: Hind Hani Abdul Wahid
Pages: 84-87
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ABSTRACT: BACKGROUND: Epileptic patients exhibited variably altered status of electrolytes, and antioxidant. OBJECTIVE: The aim of this study is to investigate the effect of epilepsy and long-term antiepileptic drug therapy on the level of serum electrolytes (calcium, sodium, and potassium) and antioxidant ( uric acid) . PATIENTS AND METHODS: Thirty epileptic patients and twenty normal healthy individuals as a control were recruited in this study. The mean± SD of age of treated and untreated patients was (24.0±10.0) and (31.0±11.0) respectively. Spectrophotometric technique was used to determine all the parameters in this study. Data were expressed as mean ± SD. Statistical comparison among different groups was performed by using ANOVA tests. Statistical significance was defined. as P<0.05. RESULTS: The treated group (particularly with valproate), show increases in the levels of calcium, sodium, with no difference in potassium. however among untreated epileptics, uric acid level was increased. CONCLUSION: The above parameters differs in epileptics comparable to controls and hence their correlation to seizures pathophysiology and their degree of control or resistance to antiepileptic drug therapy


Article
Effect of Moderate Exercise on the Level of Melatonin Hormone and Lymphocyte Apoptosis in Healthy Subjects

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ABSTRACT: BACKGROUND: Physical exercise is important for promotion of the immune system. The immune responses to exercise are dependent on the intensity and duration of the exercise performed. During exercise, metabolic and hormonal changes occurred that can induce lymphocyte apoptosis. Melatonin is one of the hormones that are affected by exercise, it is a pineal gland hormone, its production and secretion followed a circadian pattern, onset of darkness stimulate its secretion, while day light suppress its production. Melatonin is regarded as an anti-aging hormone; it has a role in the elimination of harmful lymphocytes which may give rise to chronic inflammation and possibly to autoimmunity. OBJECTIVE: This prospective study aimed to elucidate the effect of moderate endurance exercise on melatonin hormone and the percentage of peripheral blood lymphocyte apoptosis in healthy subjects. METHODS: Sixty healthy subjects with a mean age of (37.05 ± 13.02) year, participated in the study. They were subjected to moderate exercise session which lasted for 60 min and repeated 3 times per week for 3 months. The exercise intensity was 50-60% of heart rate reserve (according to Karvonen formula). Two exercise stages were performed; the first stage include 30 minute of physical activity program and the second stage include 30 minute of treadmill exercise. Blood sample were collected before and after exercise to examine its effect on the level of melatonin hormone and apoptosis of peripheral blood lymphocyte. RESULTS: This study showed significant increment in the level of melatonin hormone and the percentage of lymphocyte apoptosis after exercise in comparison to pre exercise values for each week along the period of the test (P < 0.05). Three months exercise showed a significant correlation with the levels of melatonin hormone (P= 0.008, r= 0.44), and with percentage of lymphocyte apoptosis (P = 0.001, r= 0.701). CONCLUSION: It can be concluded that moderate exercise for three months was associated with increased percentage of periphral blood lymphocyte apoptosis and increased level of melatonin hormone in the first two months while in the third month this anti aging hormone had reached a steady state after the subjects get trained to exercise


Article
The in Vitro Effect of Chloramphenicol and Salicylate on Erythrocytes of Patients with Favism

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ABSTRACT: BACKGROUND: Glucose 6-phosphate dehydrogenase (G6PD) deficiency is the most common of all clinically significant enzyme defects. A long list of drugs thought to cause haemolysis in patients with this enzyme defect. OBJECTIVE: To determine whether chloramphenicol and salicylate can act as in vitro exogenous oxidizing agents and subsequently cause haemolysis of G6PD deficient erythrocytes and matching the result with the data obtained from the clinical observations which includes the intake of trimethoprim-sulfamethoxazole, salicylate or nalidixic acid by favic patient. PATIENTS AND METHODS: Sixty six patients admitted to the hospital (Karbala teaching hospital for Children, Karbala, Iraq) with history of sudden onset of pallor and dark urine after fava beans ingestion were studied. Each patient was fully examined and his parents were asked about the type of fava beans ingested and the past drug history. Of the sixty six patients, ten were evaluated 1-3 months later and blood samples were taken from them along with blood samples from ten healthy volunteers. Blood samples from both groups were incubated in vitro with chloramphenicol and salicylate separately. RESULTS: Mean (SD) of methaemoglobin concentrations at baseline and after incubation with therapeutic and toxic concentrations of chloramphenicol (15 μg/ml and 25 μg/ml) and salicylate ( 150 μg/ml and 300 μg/ml) were calculated for both the control and the study groups. Paired t-test showed no significant differences (P> 0.05) in methaemoglobin concentrations at baseline and after incubation with therapeutic and toxic concentrations of these drugs. Mean percentage differences from baseline for G6PD deficient group were not significantly different from control group at both concentrations of these drugs as tested by student t-test. CONCLUSION:  Hemolysis in G6PD deficient patients occurs mainly after fresh fava beans ingestion.  chloramphenicol and acetylsalicylic acid do not cause significant hemolysis in G6PD deficient erythrocytes in vitro


Article
Experimental Study Using Cinnamon Oil for Prevention of Diabetic Nephropathy in Rats

Authors: Mahera N. AL – Shaikh
Pages: 101-109
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ABSTRACT: BACKGROUND: Diabetes mellitus is the leading cause of chronic renal failure. However, in the early phase of the disease before complications have set in, the glomerular filtration rate is elevated and kidney size increased. The clinical importance of these early aberrations derives from the hyperfilteration (the heightened glomerular capillary) that drives damages the glomerulus, and the enlargement of the kidney (the glomerulus). OBJECTIVE: The aim of the present investigations is to examine histologically the effect of cinnamon oil on the kidney tissues of alloxan – induced diabetes rats. MATERIALS AND METHODS: Fifty male rats were used and divided into four groups: Group I =12 animal controls, Group II =12 treated with alloxan, Group III = 12 treated with alloxan + cinnamon oil, Group IV = 12 treated with cinnamon oil only. RESULTS: Renal tissues (Bowman's capsule, proximal and distal convoluted tubules) of diabetes group: revealed obvious mesangial expansion and basement membrane thickening. While the diabetic treated animals with cinnamon oil ameliorated the increase in the mesangial area in diabetic rats. CONCLUSION: Cinnamon oil can be recommended as an support for the prevention of alloxan – induced diabetic complications.


Article
Focal Dermal Hypoplasia )Goltz Syndrome(

Authors: Luay Abdulla Al-Nouri
Pages: 110-112
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ABSTRACT: BACKGROUND: Focal Dermal Hypoplasia (FDH) is a condition of multiple features . It is important to recognize on clinical grounds , as it may show life threatening complications that need to be dealt with by properly timed interventions

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Table of content: volume:9 issue:1