Table of content

Zanco Journal of Medical Sciences

مجلة زانكو للعلوم الطبية

ISSN: 19955588/19955596
Publisher: Hawler Medical Univeristy
Faculty:
Language: English

This journal is Open Access

About

Zanco Journal of Medical Sciences (Zanco J Med Sci) is the scientific journal of Hawler Medical University. Zanco J Med Sci is a peer-reviewed, open access journal. Zanco J Med Sci aims to publish peer-reviewed and original scientific research of Iraqi, regional and international interest. Submissions of manuscripts in the clinical and basic medical sciences come within the scope of its publication. Original articles, review articles, case reports, brief communications, insights, and letters to the editor are all considered.

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Email: zanco.journal@hmu.edu.krd

Table of content: 2012 volume:16 issue:3

Article
Ethics and research
الأخلاق والبحث

Authors: Sirwan K Ali
Pages: 165-166
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Abstract

Keywords


Article
The correlation between serum high sensitivity C-reactive protein and leptin in reproductive age overweight/obese women in Erbil city
العلاقة بين مصل البروتين سي التفاعلي عالي الحساسية واللبتين لدى النساء ذوات الوزن الزائد / البدينات في سن الإنجاب في مدينة أربيل

Authors: Showan D. Hussain
Pages: 167-174
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Background and objectives: Leptin could be a key regulator of C-reactive protein (CRP) levels, which serve as a marker of systemic inflammation. Both leptin and CRP are predictors of cardiovascular disease (CVD). This study, attempted to characterize the association between inflammatory marker hs-CRP and serum leptin in overweight/obese women in reproductive age in comparison with normal body mass index women (BMI) as a control group. Methods: Eighty reproductive age women were divided into two groups: first group of 50 overweight / obese women; with mean age 27.7 years and BMI mean (31.4 Kg/m2). The second group of 30 age-matched women with mean age 28.8 years and BMI mean (22.5 Kg/m2) which served as control group. Any subject with other diseases or on medication that might affect the study was excluded. Fasting blood samples for both groups were collected and serum hs-CRP, leptin, lipid profile and glucose were measured Results: In the overweight / obese group hs-CRP concentrations were significantly associated with BMI and leptin (r =0.3, r =0.284, with p <0.05) respectively. This association remained significant, even after adjusting BMI, for each one unit increase in serum leptin the serum hs-CRP escalated by a mean of 0.05 (mg/L). Serum Leptin notably has a more significant role than BMI in explaining changes of serum hs-CRP since its standardized coefficient was higher (ß =0.384 with p=0.001) versus (ß =0.266 with p=0.016) for BMI in overweight and obese women. Conclusion: Leptin is a stronger predictor of hs-CRP than BMI in overweight and obese women in reproductive age.


Article
Effectiveness of dental health education program on periodontal health status of nursery school children in Erbil city
فعالية برنامج التثقيف في مجال صحة الأسنان على الحالة الصحية لسن أطفال المدارس التمهيدية في مدينة أربيل

Authors: Shahida Rassul Hussain
Pages: 175-179
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Abstract

Background and Objectives: Dental health education is a planned package of information, learning activities or experiences that are intended to promote dental health. The current study was conducted to evaluate the impact of dental educational program on cleanliness and gingival health in primary dentition of nursery school children aging (3-6) years in Erbil city. Methods: Oral examination was performed on (148) children of (Balla) nursery school in Erbil city. They were divided into two equal groups, each consisting of (74) children. The first group, an experimental group, received dental health education instructions for 8 weeks before clinically examining the children (the dentist with cooperation from their teachers) twice a week. The second group, control group, whose members examined clinically without any dental educational program. Index used was CPITN. Results: Clinical examination showed that CPITN of group (1) was lower with a healthier gingiva with less plaque accumulation when compared with group (2) with statistical significant differences (P-value <0.005). Conclusion: Dental health education program is an essential activity for promoting optimal oral health and preventing oral diseases. The program displayed positive influence on gingival and oral health behaviors of nursery school children.

Keywords

Dental plaque --- Gingivitis --- CPITN


Article
Coronal sealing ability of different sealers on teeth obturation and the effectiveness of two different obturation techniques
قدرة السد الإكليلي لسدادات مختلفة على تسريب الأسنان وفعالية تقنيتين مختلفتين لسد الأسنان

Authors: Dara H. Saeed --- Intesar S. Toma --- Media A. Saeed
Pages: 180-186
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Background and objectives: The purpose of this study was to evaluate the effect of two sealers on coronal seal and the coronal sealing ability of two obturation techniques. Methods: Forty extracted single–rooted human teeth were instrumented with the step-back technique and were irrigated with 5.25% sodium hypochlorite (NaOCl). The smear layer was removed by washing with 10 ml of 17% ethylene diamine tetra-acetic acid (EDTA) and 10 ml of 5.25% (NaOCl). All instrumented root canals were randomly divided into two experimental groups; Group A: 20 roots epoxy resin sealer (AH26) was used, Group B: 20 roots Zinc oxide euginol (ZOE) sealer was used. Each group of main groups were subdivided randomly into two obturation groups; 1. 10 roots obturated by thermo plasticized technique (obtura II), 2. 10 roots obturated by cold lateral compaction technique. The root surfaces were then coated with nail polish except for the coronal, then dye penetration study was conducted and samples were examined under the stereomicroscope. Data had been collected from three independent examiners and statistically analyzed using student t-test. Results: There were significant differences between AH26 with ZOE in group obturated by obtura II and when obtura II technique compared with the cold lateral compaction technique in group of AH26 sealer. Conclusion: Epoxy resin sealer (AH26) and obtura II gave the best results in coronal sealing when compared with Zinc oxide euginol sealer and cold lateral compaction technique.


Article
Management of acute otitis externa using aural wick versus local drops
معالجة التهاب الأذن الوسطى الحاد باستخدام الفتيل السمعي مقابل القطرات المحلية

Authors: Moyaser A. Yaseen --- Shilan N. Qader
Pages: 187-193
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Background and objectives: Acute otitis externa is one the commonest otological disease. In this study we aimed to evaluate its types and the possible predisposing factors as well as comparing the effectiveness between local wick and local drops in treating acute otitis externa. Methods: A prospective analysis of 100 patients complained of acute otitis externa was performed in the department of Otolaryngology at Rizgary Teaching Hospital in Hawler between August 2005 to January 2006. Male patients were 45%, and the rest 55% were females. Patients were classified into two groups; 50 patients received topical application of cream using aural wick, and the second group of 50 patients treated by topical ear drops. Results: The commonest predisposing factors were water entrance to the affected ear during bathing and swimming (51%). On culturing, bacteria were found in 64% of patients and fungi in 11%. Topical application using aural wick showed 100% response, whereas only 60% of those received topical ear drops had an immediate response. Conclusion: Acute diffuse otitis externa is the most frequent type. Pseudomonas aeruginosa is the commonest bacterial growth. Aspergillous species is the commonest caused of fungal growth. Response to aural wick treatment is much better than aural drops.


Article
Lipid profile in normal pregnancy
الشاكلة الدهنية في الحمل الطبيعي

Authors: Sinan Butrus Garabet
Pages: 194-198
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Background and objectives: Normal pregnancy is associated with disturbances in various biochemical values .The purpose of this study was to determine whether normal pregnancy is associated with any abnormalities of lipid profile. Methods: This prospective study evaluated lipid profile in 45 primigravid women during normal gestation (in the first & third trimester) and in 30 non-pregnant age matched controls for the period of December 2008 – May 2009 Results: Pregnant women exhibit a significant increase in mean serum cholesterol concentration 226.5 (S.D.42.2) mg/dL in the first trimester when compared with non-pregnant controls 167.9 (27.7) mg/Dl. The serum cholesterol increased significantly throughout gestation to a mean of 316.6 (54.8) mg/dL in the third trimester compared with the first trimester. Triglyceride panel in the first trimester had been similar to those of controls. However, by the third trimester the mean triglyceride concentration had revealed a double value of 227.7 (47.4) mg/dL; compared with the first trimester. There was no significant difference in the LDL level in first trimester when compared to control group. Nevertheless, it increased significantly, from 93.6 (11.9) mg/dL during the first trimester to 178.6 (18.5) mg/dL in the third trimester Conclusion: Atherogenic lipid profile develops during normal gestation. The future significance of these changes remains to be determined. They may have important implications for the mother and fetus.


Article
Clinical and haematological parameters in adult AML patients: a four year experience at Nanakaly hospital for blood diseases
المعلمات السريرية وأمراض الدم لدى مرضى AML البالغين: تجربة مدتها أربع سنوات في مستشفى نانكلي لأمراض الدم

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Background and objectives: In adults, acute myeloid leukaemias constitute 80% of all acute leukaemia cases; its incidence progressively increases with age To define the clinical and haematological parameters of adult acute myeloid leukaemia in Erbil City. Methods: A painstaking analysis of hospital records of 94 adult patients with acute myeloid leukaemia was undertaken. The cases were diagnosed and managed at Nanakaly hospital during the years 2006-2009. Diagnosis was based on peripheral blood and marrow findings. The myeloid origin was confirmed by cytochemistry, and morphological subtyping was done according to the French-American-British (FAB) criteria. Microsoft excel version 2007 was employed for carrying out statistical analysis. Results: The studied group included 58 males and 36 females (M: F = 1.6:1). Their ages ranged between 16 and 75 years with a mean age of 33.8 years. Pallor was the commonest presenting feature (70.2%) followed by bleeding (22.3%) then fever (7.5%). The mean value of Hb was (7.6) g/dl, WBCs (34.5 x10­6/L), platelets (39.6 x10­9/L); the percentage of blast cells in peripheral blood was 42.5% and in the bone marrow was 65.9%. AML-M2 was the most frequent FAB subtype 24.4%. Conclusion: AML was commoner in males than in females (1.6:1). AML-M2 was the commonest FAB subtype. Pallor was the commonest presenting feature. Sudan black-B stain was a useful tool in the diagnosis of myeloid leukaemia .


Article
The influence of type I diabetes mellitus on dentition and oral health of children and adolescents attending two diabetic centers in Erbil city
تأثير داء السكري من النوع الأول على طب الأسنان وصحة الفم للأطفال والمراهقين الذين يحضرون مركزين لمرضى السكري في مدينة أربيل

Authors: Vian O. Majeed --- Sazgar M. Saber --- Hemn M. Sarmamy
Pages: 204-212
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Background and objectives: The aim was to determine the effect of type I diabetes melli-tus on eruption time of dentition and to evaluate the dental caries, debris, calculus and gin-gival index in two groups. Methods: Type I diabetic children and adolescents with age range (6-14) years who were attending to Layla Qasim Center for Diabetes and The Diabetic Child Association Center in Erbil city were included in this study from December 2010 to March 2011. The dentition of all participants was examined for eruption. Besides, the DMF/dmf index, debris index (DI), gingival index (GI) and calculus index (CI) were evaluated. Data obtained from each group were compared statistically. Results: When compared to the non-diabetic group, we observed that dental development was as early as (1.6) years in diabetic group. Results also showed that the total mean value of caries experienced (dmft, dmfs,DMFT and DMFS) by the diabetic group was less than that of the control group with significant differences. The gingival index among dia-betic group was higher than the control group. The total mean value of simplified debris index in control group was higher than the diabetic group. In contrast, simplified calculus index was less in diabetic group with a significant difference between them. Conclusion: The findings showed that patients with type I diabetes mellitus had an earlier tooth eruption and plays an important part in the oral health of children.


Article
Mother’s knowledge over child-toilet training in Sebardan village in Erbil
معرفة الأم بتدريب المرحاض للأطفال في قرية سيبردان في أربيل

Authors: Kareema Ahmad Hussain
Pages: 213-219
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Background and objectives: Child toilet training is a paramount skill to learn, it virtually involves many steps for parents to endorse should the child success. The aim of the study was to assess mother’s knowledge about child-toilet training in Sebardan Village in Erbil. Methods: A cross-sectional descriptive study was carried out in Sebardan Village in Erbil Governorate from the 1st / March / 2010 to the 30th / May / 2010. A convenience sample of 300 mothers with their children under the age of five years old was selected. Results: Less than half (31.4%) of the mothers age were between 21-25 years old, (85.4%) of them were housewives, (34%) completed a primary school and all of them were from the rural areas. Less than half (40.4%) of mothers whom their male children exhibited physical readiness to reduce their number of wet diapers. Conclusion: Our survey concluded that mother’s knowledge had an effect on the child’s readiness for toilet training, and highly significant relationship between mother's level of education and their knowledge of their child’s readiness (physical, mental and psychologi-cal ) toward toilet training at p ≤ 0.05. The study has been recommended to provide guid-ance through the media and different community health centers to promote parental aware-ness toward developmental milestones and child-toilet training.


Article
Seroprevalence of human brucellosis in Erbil city
الانتشار المصلي لداء البروسيلات البشري في مدينة أربيل

Authors: Isam Yousif Mansoor --- Dlsoz Kareem Rasul
Pages: 220-226
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Background and objectives: Brucellosis is an acute or chronic illness manifested princi-pally by chills and fever. Occasionally, chronic relapsing febrile episodes occur. Brucellosis is endemic in animal and humans are infected incidentally. The aim of the study was to ex-amine the incidence of brucellosis in Erbil City, study the relation between the rate of infec-tion and a number of predisposing factors. Methods: Blood samples were collected from (2085) patients suspected of having brucel-losis attending, Erbil Teaching Hospitals and Rizgary. The sera were examined using Rose Bengal test. Results: Serum samples from patients showed (10.7%) of positive reaction indicating the presence of anti-brucella antibodies. Seropositivity of brucellosis in female (12.48%) was significantly higher than male (8.02%), and in rural area was (40.98%) and in urban area was (9.44%). The highest seropositivity of brucellosis occurred among age group (21-30) years. The infection rate with B. miletensis and Brucella abortus was (71.75%) and (28.25%) respectively. The highest seropositivity occurred among individuals who were in contact with animals (37.34%), and in occupations was the highest among the farmers and dairy workers (37.5% and 37.28%) respectively. In Monthly distribution showed the highest sero-positivity occurred in October (12.72%). Conclusion: Sero-posivity of brucellosis in Erbil City is somehow similar to the neighboring countries. There are variations in the incidence of brucellosis in relation to sex, age, area, occupation, source of infection and seasons.


Article
The frequency of agoraphobia and the comorbidity of major depressive disorder in panic disorder
تواتر الخوف من المرض والاعتلال المشترك للاضطراب الاكتئابي الرئيسي في اضطرابات الهلع

Authors: Diyar Hussain Tahir
Pages: 227-232
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Background and objectives: Panic disorder (PD) is a common disabling psychiatric con-dition that has a considerable impact on the quality of life. This study was done to estimate the frequency of agoraphobia and the comorbidity of major depressive disorder (MDD) in PD, with related sex difference. Methods: A cross sectional descriptive study, was done on patients who consulted a pri-vate psychiatric clinic for features of PD, in Erbil city from August 2009 to August 2010. A convenient sample of 118 patients, 73 females and 45 males, having PD with or without agoraphobia were taken after giving their informed verbal consent. All patients were checked for the presence of MDD. The diagnoses were done clinically, and then checked according to the diagnostic and statistical manual of mental disorders, 4th edition, text revi-sion (DSM-IV-TR). Results: Mean age of PD with or without agoraphobia was 31.1 years. Female to male ra-tio was 1.6/1. Mean age at onset was 26.3 years. Mean duration of illness was 4.4 years. Patients having PD without Agoraphobia were 81.4%, while having PD with agoraphobia were 18.6% in which the males (20%) affected more than females (17.8%). The comorbid-ity rate of MDD (mild to severe degree) in PD was 61% with higher males (68.9%) than fe-males (57.5%). Conclusion: The majority of patients with PD in our sample had a comorbid MDD. Early detection and management of PD is necessary to reduce complications and improve their quality of life.


Article
The role of FNA cytology of the testis in management of male infertility (in Iraq)
دور دراسة علم الخلايا بابرة دقيقة في الخصية في معالجة العقم عند الذكور (في العراق)

Authors: Suhel M. Alnajjar --- Salah A. Ali
Pages: 233-240
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Background and objectives: Fine needle aspiration cytology of the testis is now well recognized in diagnosis of testicular diseases. Recently it has also gained popularity for its diagnostic and therapeutic role in male infertility. The purpose of this article is to put light on role of testicular fine needle testicular cytology in male infertility and provide brief information on method of testicular fine needle aspiration interpretation of testicular fine needle aspiration cytology for evaluation of spermatogenesis, its advantages, limitations and complications as compared to testicular biopsy, moreover to its coincidence with hormonal situation of the patient for diagnosis. Methods: This is a prospective study for sample collection during the period from January 2009-Dec 2010. The samples studied included 152 patients underwent FNA of testis for evaluation of spermatogenesis , spermiogenesis & the presence of active mature sperms in addition to hormonal assay for FSH, LH, testosterone and prolactine correlating with clinical findings Results: : The majority of cases of infertility were due to secondary maturation arrest (94 cases 61.84%) (P=0.03) followed by obstructive orchiopathy (38case 25%) & then the minority of cases were due to untreatable conditions including primary maturation arrest & total testicular atrophy Conclusion: FNAC is the dependent method of Azospermic patient evaluation despite of the presence of controversial ideas depending on that the FNAC size is not a suitable window to be able to represent whole testis in evaluation of azospermia.


Article
Oral Tori In Edentulous Patients
توري عن طريق الفم المرضى

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Background and objective: This study aimed to determine the prevalence, size, shape and location of tori in partially and completely edentulous patients attending the College of Dentistry/ Hawler Medical University from 2009-2011. Methods: In a retrospective study four hundred and fifty patients case file from Erbil city were examined for the presence of oral tori in prosthodontic department, College of Den-tistry, Hawler Medical University. The size, shape and location of tori were recorded and related with the age and sex of patients. Results: The overall prevalence of tori was 14.2% (64 cases). The prevalence of torus palatinus was 60.9% (39/64), while that of torus mandibularis was significantly lesser 23.5 % (15/64).Both types of tori were associated with each other in 15.62% of cases (10/64). Conclusion: There was no statistically significant difference in the prevalence of tori be-tween males and females. There was a significant relationship between the presence of mandibular and palatal tori.


Article
A study of p53 expression in transitional cell carcinoma of urinary bladder in Erbil governorate
دراسة تعبير p53 في سرطان الخلايا الانتقالية للمثانة في محافظة أربيل

Authors: Bakir Sadeq --- Salah A. Ali
Pages: 248-255
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Background and objectives: This study aimed to evaluate p53 protein expression in both normal bladder epithelium and in cases of transitional cell carcinoma (TCC) of urinary blad-der by immunohistochemical study and to correlate p53 expression in urothelial cancer with other clinico-pathological parameters. Methods: This is a retrospective and prospective study for sample collection during the period from January 2006-May 2009. The samples studied included 105 formalin fixed, paraffin embedded urinary bladder tissue specimens; they consisted of the following diag-nostic categories: chronic non specific cystitis (n=5) and urothelial cancer (n=100). In this study the nuclear p53 protein expression was detected in tissue samples by Dako Cytoma-tion. LSAB + System-HRP staining protocol using monoclonal mouse anti human protein DO-7. Results: None of the chronic non specific cystitis cases showed p53 nuclear immunostain-ing, while 93% of urothelial cancer specimens examined showed immunopositivity for p53 protein. In this study, a statistically significant correlation was observed between p53 over-expression rate with the tumor grade (p= <0.001) and histological architecture (p= 0.023), but not with other clinico-pathological parameters like age and gender. Conclusion: Results of the present study showed the validity and simplicity of application of immunohistochemistry in determining the status of p53 protein expression. The results suggest that p53 overexpression is strongly associated with the aggressiveness of urothe-lial cancer.


Article
Blood pressure changes following extracorporeal shock wave lithotripsy in Kirkuk province
تغير ضغط الدم بعد تفتيت الحصى من موجة الصدمة خارج الجسم في محافظة كركوك

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Background and objectives: : Hypertension has been reported as a possible sequela of extracorporeal shock wave lithotripsy. The aim was to determine, in a clinical trial, the ef-fect of extracorporeal shock wave lithotripsy (ESWL) on blood pressure Methods: This study included 216 patients, aged (12-65) years, with asymptomatic renal stones that underwent ESWL in lithotripter unit/ Azadi teaching hospital –Kirkuk Province. Blood pressure was recorded randomly using a standardized protocol. Patients undergoing ESWL received a mean (±SD) of 3608.8 (±475.9) shocks over a mean (6.81) of sessions on one lithotripter. Patients were then followed-up by assessing their blood pressure. Data were analyzed on an intention to treatment basis. Results: At randomization (13.42) % of the study group were hypertensive. Of (320) pa-tients referred to the study, (258) were recruited based on the inclusion and exclusion crite-ria. A total of (216) patients (83 % of patients included) completed follow up, (137) (63.42%) were male and (79) (36.57%) were female. The mean follow-up period was (15.03) months. In the present study there was no association between mean diastolic and systolic blood pressure before and after ESWL. Conclusion: : In the present study there was no evidence that ESWL causes changes in BP. More randomized control trials are needed to demonstrate the relationship between ESWL and hypertension.

Keywords

ESWL --- Hypertension --- Clinical trial


Article
Risk factors of breast cancer in a sample of Kurdish women of Kurdistan region - Iraq: A comparative study between pre-menopausal and post-menopausal women
عوامل خطر الإصابة بسرطان الثدي في عينة من النساء الكورديات في إقليم كوردستان - العراق: دراسة مقارنة بين النساء قبل انقطاع الطمث وما بعد انقطاع الطمث

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Background and objectives: To evaluate the difference between pre- and post-menopausal breast cancer regarding menstrual and reproductive risk factors for ca breast.. Methods: A prospective case-control study was conducted in Nanakaly Oncology Hospital in Erbil city-Kurdistan- Iraq, between September 2009 and April 2011. Cases were breast cancer patients admitted in the oncology floor of the hospital. Controls were hospital pa-tients without breast cancer (other cancers). The study enrolled 300 cases and 600 con-trols. Menstrual and reproductive history was taken from both the cases and the controls. For every risk factor age-adjusted odds ratio (OR) and 95% confidence interval (CI) was calculated by logistic regression analysis, separate for pre- and post-menopausal women . Results: Among the breast cancer patients, 42.7% were pre-menopausal and 57.3% were post-menopausal. Age at menarche had no association with breast cancer for both pre- and post-menopausal women. Nulliparity was a risk factor for both pre-menopausal (OR = 2.42, 95% CI (1.1-4.6) and post-menopausal breast cancer (OR = 3.7, 95% CI (2.04-6.87)). Among parous women only post-menopausal females having <3 children were at in-creased risk for breast cancer (OR = 2.18, 95% CL (1.45-3.27) compared with females having > 3 children. Younger age at first live birth decreased breast cancer risk in both pre- and post-menopausal women. Breastfeeding was not associated with both pre- and post-menopausal breast cancer. Conclusion: Majority of risk factors for pre-menopausal breast cancer are also associated with post-menopausal breast cancer except less parity, which increased the risk for post-menopausal breast cancer only.


Article
A child with obesity and polydactyly
طفل يعاني من السمنة و كثرة الاصابع

Authors: Yousif Baha’addin Ahmed
Pages: 268-270
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Bardet Biedle syndrome is a rare genetic disorder related to Laurence moon syndrome. It is characterized by obesity, hypogonadism, polydactyly, renal abnormalities, retinal pigmentation, and other features, some patients has mental retardation and other clinical findings. Situs inversus is very rarely reported as an association of this syndrome, The cause of this syndrome is genetic with multiple genes involved, it is usually inherited as autosomal recessive pattern .There is no any proved treatment for this syndrome apart from dealing with specific problems which might have been arisen. We presented a 6 years old boy patient exhibiting characteristic features of this syndrome with additional rare associated features that make the case unique and discrete. In the setting of this case, the literature about Bardet Biedl syndrome was reviewed.

Table of content: volume:16 issue:3