Home | Journal Issues | Vol.58. Issue , No. : 3. , 2016
58-3

Vol.58. Issue , No. : 3. , 2016

published 1/10/2016



articles...


  • Article title : Molecular Classification of Iraqi Breast Cancer Patients and Its Correlation with Patients’ Profile
    Description :

    Khudair J. Al-Rawaq* MBChB, DMRT
    Manwar A. Al-Naqqash* MBChB, DMRT, MSc Pathology
    Mustafa K. Jassim** MBChB
    Abstract:
    Background: Breast cancer is a complex, multifaceted disease encompassing a great variety of entities that show considerable variation in clinical, morphological and molecular attributes.
    Objective: The aim of this study to evaluate patients’ molecular profile (Estrogen receptor, Progesterone receptor, HER2/neu and Ki-67).
    Patients & Methods: This is a cross-sectional descriptive study was done in Baghdad oncology teaching hospital from December 2015 to April 2016, carried on 100 breast cancer female patients with their age range from 27 to 73 years old and with their histopathology reports and (IHC) results.
    Results: The highest incidence of breast cancer among patients in 5th (40-49 years) and 6th (50-59 years) decades of life both groups are (32%), estrogen and progesterone values were observed (74% and 75% respectively) and 69 patients (69%) with Ki-67 ≥14.
    Conclusions: Most of the breast cancer patients in the current study were estrogen and progesterone (Hormonal) positive, and Luminal B-like was the most common molecular subtype (53%) due to high Ki-67 index. There was a strong correlation between estrogen and progesterone in the studied patients with highly significant P value <0.0001.
    Keywords: Breast cancer, Luminal B like, estrogen, progesterone

    pages: 197-201

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  • Article title : Assessment of early side effects of radiotherapy in breast cancer patients
    Description :

    Elaf A. Hussein* MBChB
    Khudair J. Al-Rawaq* DMRT
    Abstract:
    Background: Breast cancer is the commonest cancer in women. In radiotherapy practice, it comprises 25% of patient caseload. This makes understanding the breast irradiation toxicities of prime importance. Early radiation toxicities occur during treatment and up to six months after treatment finished.
    Objectives: assessment of the early side effects of adjuvant external beam radiotherapy (EBRT) in breast cancer patients.
    Patients and Methods: A cross sectional survey with analytic component conducted on 60 patients treated in the oncology teaching hospital of medical city from January to April 2016.
    Results: The most prevalent toxicities were radiation dermatitis, fatigue, pain, sore throat, nausea, dysphagia, and arm edema. There was a significant difference between prevalence of dermatitis with different radiation doses used. Dermatitis was more prevalent with conventional fractionation (CF), than in hypofractionated radiotherapy.
    Conclusion: Dermatitis was the most common acute toxicity of radiotherapy in breast cancer patients with prevalence of 81.6 %. It was related to dose fractionation. Fatigue was the 2nd common (70%). It was correlated with disease stage.
    Keywords: Breast cancer, Conventional fractionation, Hypofractionation, Radiation Dermatitis, Fatigue, Sore throat.

    pages: 202-207

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  • Article title : Evaluation of Ionizing Radiation Protection among Radiation Workers in X-ray departments in Erbil City
    Description :

    Runak T.Ali* BSc, PhD
    Safa M. Hameed** BSc, PhD
    Qasim A. Ali*** BSc, MSc
    Abstract:
    Background: Ionizing radiations are hazardous agents in the workplace, since all forms of ionizing radiation produce some type of injury that is incurable. Therefore, protection against ionizing radiation exposure can play an important role in the health of workers.
    Objectives: is to evaluate the application of radiation protection among radiation workers at X-ray department in Erbil hospitals.
    Patients and methods: Six hospitals (General and Private) were visited. Samples of 110 were randomly selected among 135 radiation workers, 47 (42.3%) female and 63 (57.3%) male Data was collected through structured questionnaires. The surveyed data was coded and analyzed by using MS Excel software, and SPSS 18 for analysis. Analysis was performed by means of frequency distributions and cross tabulations.
    Results: The results showed that there are majority of the workers 51 (46.4%) aged between 21 - 30 years, and Diploma holders 68 (61.8%). Only 49 (44.5%) undergone primary examination while 47 (42.7%) never done periodical examination. According to international commotion of radiation protection regulation of radiation protection, it is mandatory for radiation workers to wear personal detective devices during work. But a large numbers 89 (80.9%) have not supplied with such devices. The study also revealed that the majority of workers were engaged in work beyond 40 hours per week. Calibration of the X-rays machine and radiation survey of the work place have not been regularly done. Only 30 of the sample have no awareness and knowledge about the ionizing radiation, while 95 (86.4%) have no healthy advice.
    Conclusion: It can be suggested that the level of workers education must be increased and short courses be implemented such as dosimetery and radiation protection performance.
    Keywords: Radiation workers, Radiographers, Radiation protection.

    pages:208-212

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  • Article title : Evaluation of triple hormonal content (ER, PR, and HER\2neu)of breast cancer specimens obtained from breast cancer patients using tru-cut biopsy
    Description :

    Mustafa H. Jasim* CABS
    Mohammed A.-Zaid Akool* FIBMS, MRCS, FACS
    Safa M. Al- Obaidi* FRCS, FACS
    Abstract:
    Background: Breast cancer is the commonest type of malignancy among women worldwide and in Iraq. Tru-cut needle biopsy technique provides adequate tissue for histopathological diagnosis of suspected breast lumps and assessment of hormonal receptors (estrogen, progesterone and HER2neu) prior to surgical operation.
    Objectives: To assess estrogen, progesterone andHER2neu expression using breast cancer tissue specimens obtained by tru-cut biopsy, to correlate the findings with clinicopathological parameters of known prognostic significance in breast cancer patients.
    Patients and Methods: This prospective study was held within the Main Referral Center for Early Detection of Breast Tumors/Medical City Teaching Hospital and the Iraqi National Cancer Research Center/Baghdad University from May 2012 to the end of December 2012. Sixty-two females aged 25-73 years who presented with a breast lump were involved and examined using the triple assessment technique. A triple hormonal assessment (ER, PR & Her2) of the examined biopsies obtained by tru-cut needle for patients with suspected breast cancer was performed. The results were compared with the corresponding clinical and pathological parameters.
    Results: Data for excisional biopsy were available for 25 cases of the total number of women presented with breast lump. All of these cases showed similar histopathological results compared to Tru-cut biopsy results. Non-significant correlation was found between expression of ER, PR and HER2neu and the age of women, family history, and the site of the lump.On the other hand, a significant relationship was displayed between HER2neu over expression and the histopathological grading and age of the breast cancer patient.
    Conclusion: Tru-cut needle biopsy technique should be promoted nationwide in surgical departments to provide an insight to the type of mammary carcinoma, its aggressiveness, hormone receptor content and predict response to primary therapy before mastectomy.
    Keywords: fine needle aspiration cytology, the national health service breast screening program, estrogen receptor, human epidermal growth factor.

    pages:213-220

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  • Article title : The significance of incidental breast findings on routine computed tomography of the chest
    Description :

    Mohammed Al-Hilli* DMRD, FICMS(RAD)
    Abdullateef A. Mustafa** CABMS-RAD
    Hiba M. Abdul Wahid** MBChB
    Abstract:
    Background: with the dramatic increase in the use of chest computed tomography (CT) for diagnostic or screening purposes, incidental breast lesions faced more frequently; while most of these incidental breast findings are benign; nevertheless, breast cancer be existing.
    Objectives: to determine the imaging characteristic of incidentally detected breast lesions in routine chest computed tomography and to review the outcome of further assessment of these abnormalities.
    Patients and methods: a prospective study performed on (33 patients) during the period from October 2014 to November 2015 in AL Shaheed Ghazi Al Hariri hospital, Baghdad teaching hospital, and Radiology Institute at Medical city complex, Baghdad. All patients were female and their ages ranging from (18-74) years. Then breast lesions found incidentally at CT scan identified and their CT features analyzed and include number of lesions, size, location, shape, margin characteristics, and density of the lesion and associated calcification. Most of these patients with incidental breast findings were followed up by performing breast ultrasound (US) and/or mammography in oncology teaching hospital (according to their age) and according to breast imaging and reporting data system (BIRADS); BIRAD- IV and V lesions followed by cytopathological examination and final results were recorded.
    Results: during the study period, a total of 39 incidental breast lesions were identified on chest CT scan among those 33 patients because some patients had multiple lesions. The mean age of patients for malignant lesions was (53±6.1 years) and for benign lesions was (43.21±0.8years). 25.6%, of incidental, breast lesions found to be malignant and 74.4% found to be benign. Malignant incidental breast lesions tend to have an irregular shape, ill-defined margin and have soft tissue attenuation.
    Conclusion: Although CT scan is not the primary procedure for the breast imaging, but it can show a significant complementary role in the evaluation of the breast with ultrasound and mammography. A careful review of the breast and accurate characterization of incidental breast lesions (IBL) would highlight the radiological reports, it would achieve appropriate management for the patients, and this would improve survival. Although some of the findings of benign and malignant breast lesions on CT scan do overlap to some degree, we can conclude that an irregular shape and ill-defined margin are important features that go with malignant breast lesions.
    Key words: incidental, breast, computed tomography.

    pages:221-228

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  • Article title : The predictive value of selected ultrasound features in evaluating malignancy in thyroid nodules
    Description :

    Waleed Q. Rajab* FICMS
    Ahmed S. Khazaal* FICMS
    Mohammed M. Habash** FICMS
    Rana Z. Hussien*** GB ridioloy
    Abstract:
    Background: Thyroid ultrasound has been widely used to differentiate benign from malignant nodules; many investigators have tried to point out few ultrasonographic features in order to identify those lesions, which are at a higher risk of malignancy.
    Objectives: To evaluate the efficacy of selected conventional ultrasound (US) features of thyroid focal lesions useful for predicting malignancy and establishing indications for fine-needle aspiration cytology (FNAC).
    Patients and Methods:Two hundred and four consecutive patients with thyroid nodules who visited the outpatient clinic of the surgical department of Tikrit University teaching hospital for the period from January 2011 to April 2014, and who underwent surgery for clinical suspicion of malignancy; were examined by US before thyroidectomy. Conventional US evaluated the presence of a halo sign, hypoechogenicity and microcalcifications.
    Results: On histology, 60 nodules were diagnosed as malignant and 148 as benign nodules. On US, the echographic pattern most predictive for malignancy was microcalcification (P = 0.0001; specificity 78.0%; sensitivity 67.6%). The most specific combination on US, absent halo sign/microcalcifications (P < 0.005; specificity 92.2%, sensitivity 27.6%).
    Conclusion: Findings on US become effectively predictive for malignancy only when multiple signs are simultaneously present in a thyroid nodule. Thus the predictive value of these techniques increases at the expense of their sensitivity.
    Key words: Ultrasound, Thyroid, Nodule, Malignancy, Feature.

    pages:229-232

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  • Article title : The effectiveness of irrigation method by normal saline compared to povidone iodine soaking in decreasing the rate of contamination in appendectomy wound
    Description :

    Hassan A. Hassan* FRCS
    Mohannad K.Al-Bermani** FICS
    Aws B. Abed* FICS
    Abstract:
    Background: The number of bacteria is important as much as the type of it in developing wound infection. Pressurized irrigation of the surgical wound leads to decrease bacterial number which led to decrease incidence of wound infection.
    Objective: to evaluate effectiveness of normal saline irrigation and povidone iodine soaking in decreasing the number of bacteria.
    Patient and method: This was a prospective study of 100 patients who were admitted to Al Kadhimyia Teaching Hospital during the period from May 2012 and April 2013 with diagnosis of acute appendicitis. After appendicectomy was done, patients were randomized into two groups, fifty patients (group one) the subcutaneous tissue was irrigated by 200 ml normal saline. The subcutaneous tissue of the other fifty patients (group two) was soaked by 10 percent povidone iodine solution. Swabs were taken from subcutaneous tissue before and after irrigation or soaking in both groups. All swabs were implanted in special type of agars. The number of colonies appeared represents the number of bacteria that grow under the incubation conditions employed.
    Results: there was a significant reduction in the number of bacterial colonies in group I; compared to group II.
    Conclusion: Irrigation of the subcutaneous tissue with normal saline is an effective method in decreasing the rate of bacterial contamination when compared to the use of povidone iodine soaking.
    Keywords: Normal saline, povidone iodine, irrigation, wound infection, contamination, bacteria.

    pages:233-237

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  • Article title : Non discogenic lumbar radiculopathy ((A study of 104 cases))
    Description :

    Ali T. AbdulWahid* FIBMS
    Abstract:
    Background: All though the most common etiology of lumbar radiculopathy is herniated disc or spinal stenosis, however there are several intraspinal or extra spinal pathogenic processes that may cause lumbar radiculopathy.
    Objective: To assess how often, and review the pathologies that cause non discogenic lumbar radiculopathy.
    Patients and Methods: A prospective study was conducted on 600 patients who had lumbar radiculopathy. During one year period we examined 600 patients in outpatient clinic with presumed diagnosis of lumbar disc herniation.Through history and comprehensive physical and neurological examination were performed for all patients. Diagnostic test were done including laboratory, electrophysiological and radiological assessments. in this study Patients with non discogenic lumbar radiculopathy, were refereed patients to other specialist to deal with cases.
    Results: There were 104 patients (17%) with non discogenic lumbar radiculopathy out of 600 patients presented with lumbar radiculopathy. There were peripheral neuropathy in 28.8%, peripheral vascular diseases in 19.25%, osteoarthritis or osteonecrosis of hip joint in 19.25%, extra spinal tumors in 14.5% of patients ,osteodiscitis in 11.5%, entrapment neuropathy in 6.5% of the patients.
    Conclusions: The most common causes of lumbar radiculopathy are herniated disc but there are 17% with non discogenic lumbar radiculopathy with broad list of pathologies.
    Key Words: discogenic, lumbar, radiculopathy, nondiscogenic, spine.

    pages:238-240

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  • Article title : Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy
    Description :

    Adil K. Saloom* CABS, MRCS
    Mohammed Q. AbdulJabbar** CABS DGS
    Abstract:
    Background: Thyroid surgery has undergone many changes during the past 2 decades, including the introduction of new surgical techniques such as endoscopic or video-assisted approaches, anesthesia care, intraoperative nerve monitoring and new hemostatic tools
    Objectives: to assess the efficacy and safety of Harmonic Focus shears in total thyroidectomy compared with conventional surgical technique.
    Patients and methods: prospective study conducted from October 2011 till January 2016, two handers and nine patients with benign and malignant thyroid diseases, scheduled for total thyroidectomy in a governor and private hospitals were enrolled randomly into 2 groups, group A consists of 105 patient who undergone a total thyroidectomy using a harmonic FOCUSTM , and group B consists of 104 patients who underwent total thyroidectomy with conventional surgical technique.
    Results: Eleven patients had papillary thyroid carcinoma: 6 (5.7%) of them in group A and 5(4.8%) in group B. Eighty seven (82.9%) patients in group A had non toxic MNG, and 12(11.4%) patients had toxic MNG, 90 (86.5%) patients in group B had non toxic MNG while the other 9 (8.7%) had toxic MNG. Mean operative time was significantly lower in group A compared to Group B (100+/- 34 vs. 119+/- 30mins, respectively). In group A mean calcium level at first post-operative day was 8.36 +/- 0.54 mg/dl. In group B mean value was 8.12+/- 0.56 mg/dl. This difference was not statistically significant. There were no significant difference between the two groups concerning transient hypocalcemia requiring calcium and Vitamin D therapy: 11(10.5%) patients in group A versus 12(11.5%) in group B. No permanent hypocalcemia was found in both groups. Two patients had transient vocal cord palsy in group A(1.9%) versus 3 patients in group B (2.8%)
    Conclusions: The HF is a reliable, comfortable and safe instrument alternative to knot tying technique, very suitable hand-piece for total thyroidectomy. It creates a clean, bloodless surgical field, and there is an advantage for the surgeon to use a single tool for both dissection and hemostasis. Moreover, the HF is a time-saving option, allowing for a significant reduction of operative time, without affecting parathyroid function, need for medical therapy, and hemostasis in the early post-operative period.
    Keywords: Harmonic Focus, Total thyroidectomy, hypocalcemia, operative time, recurrent laryngeal nerve injury.

    pages:241-244

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  • Article title : Incidental thyroid carcinoma
    Description :

    Mohammed Q. Abdul Jabbar* MBChB DGS CABMS
    Nofel Sh. Mutlak** FICMS CABMS MRCS
    Waleed Abdul Hussein** MBChB FICMS
    Tharwat I. Sulaiman** FRCS FACS CABMS
    Abstract:
    Background: thyroid carcinoma is the most common endocrine carcinoma as it accounts for almost 90% of all endocrine malignancies. The term incidental denoted malignant tumors of the thyroid gland detected by post-operative biopsy results of the resected specimens resected from benign thyroid diseases. Among the incidental thyroid malignancies, papillary carcinoma is the commonest pathological type.
    Objectives : To determine the incidence of incidental thyroid carcinoma and to insist on accurate preoperative diagnostic work up of patients with thyroid diseases.
    Patients & Methods: A prospective study, which was conducted during the period from March 2013 to April 2014 at Baghdad teaching hospital first surgical unit by the same team of surgeons. Ninety nine patients were referred for surgical treatment of goiters, 4 patients who had a known malignant diagnosis by FNAC were excluded from the study, the remaining 95 patients were evaluated for the presence of the cancer by post-operative pathological exam. The surgical operations performed were total lobectomy with isthmusectomy, subtotal, near total or total thyroidectomy.
    Results: incidental thyroid carcinoma was found in 18 patients (18.9%), 15 patients with non-toxic MNG (15.7%), 2 patients with solitary thyroid nodule (2.1%) and one patient (1.1%) with toxic MNG. Out of 18 patients with incidental thyroid carcinoma, 15(83.3%) aged >45 and the remaining 3 (16.7%) aged≥45, only one male had ITC and the remaining patients were females.
    Conclusions: It can be concluded that the incidence of incidental thyroid carcinoma in our study is relatively high so a more radical surgical treatment in the management of patients with presumably benign thyroid disease is recommended.
    Keywords:incidental thyroid carcinoma, micro-papillary carcinoma, total thyroidectomy.

    pages:245-249

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  • Article title : Assessment of Treadmill Exercise Test Preparation in Mosul Cardiac Center
    Description :

    Zahraa H. Ismaeel AL-Ridhwany* FICMS(F.M)
    Zaid Abedel-Elah Mustafa Al- Najjar** FICMS(med.)
    Salah Mahdy Majeed*** FICMS(med.),CABMS(med.),FICMS(cardio.)
    Abstract:
    Background: The exercise ECG has a role in articulating the clinical history through stimulating symptoms such as chest pain (which is the most common presenting complaint indicating coronary artery disease and is seen frequently by primary care physicians) and breathlessness, and prompting additional details about their symptoms so it can facilitate communication between patient and clinician as the evaluation of chest pain can be very difficult since it is possible to have a normal resting ECG with considerable narrowing of the coronary arteries.
    Objectives: This study sought to assess the roles of preparation for treadmill and the frequency of inconclusive result.
    Methods: The study sample consisted of persons of all ages and both sexes attending the exercise units during the study period in Mosul city, Iraq were included in the research and the collection of cases started from the 1st of January 2012 to 1st of June 2012.
    Results: The present study included a sample of 593 patients during the study period. The mean age of patients was 49±9 years. Mean age of males patients (48.7±9 years) compared with the females’ mean age (50.3±8 years) (p=0.000). The percentage of unprepared group for testing in the present study sample were 23.1%, a condition that was significantly associated with inconclusive result in general (p=0.000) and incomplete result in specific (p=0.001). On the other hand, 67.9% of patients were well prepared.
    Conclusion: It was concluded that patients must be well prepared for exercise tolerance test. They should not only know the purpose of the test, but also signs and symptoms that indicate the test should be stopped.
    Keywords: Treadmill exercise, Patient preparation, Accuracy of result.

    pages:250-254

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  • Article title : The strategy of paracetamol (acetaminophen) use in closing patent ductus arteriosus in premature neonates.
    Description :

    Khaleel I. ALSuwayfee* FIBMS
    Abstract:
    Background: Patent ductus arteriosus (PDA) is a common problem in premature neonates which can be closed pharmacologically using nonsteroidal anti-inflammatory drugs (NSAIDs) with many side effects. Recently paracetamol is used in this field when these drugs can not be used like in cases of gastrointestinal (G.I.T) bleeding or perforation, or if the patient doesn’t show response to the NSAIDs and it seems to be of good safety. To the best knowledge this is the first paper that describes in details the strategy of using paracetamol in closing PDA in premature neonates and gives recommendations about this therapy.
    Objective: To give a guide and recommendations about using paracetamol in closing PDA in premature neonates regarding dosage regimen, route of administration, and about how to select and evaluate the patients before and during this therapy.
    Patients and Methods: A web search was done in MEDLINE, SCOPUS, Cochrane library and ISI Web of Knowledge databases as well as electronic and manual screening of conference abstracts from international meetings of relevant organizations using the words acetaminophen, paracetamol, patent ductus arteriosus, preterm and premature for all English written publications (case reports, case series and studies with no date restrictions) related to the topic.
    Results and data synthesis: Twenty article of different types have been evaluated. Best candidates were those premature babies with hemodynamically significant (hds) PDA and had no contraindication for paracetamol therapy. Generally success rate was ranging between 70-100 % using oral or intravenous (IV) paracetamol in a dose of 30-60 mg/kg/24 hours (h) divided every 6-8 h .Therapy commonly started after 48 h of postnatal age, patients were maximally given 2 courses during 7 days period. Pretreatment evaluation included clinical, echocardiography, cranial ultrasonography, liver function tests (LFT), renal function tests (RFT) and platelet count; and the same parameters were used during daily follow up of the patients.
    Conclusion: Paracetamol found to be the best choice for pharmacological closure of PDA in premature neonates if they are not responding to the other NSAIDs or when they are contraindicated. Patients should not have contraindications for this therapy and paracetamol was used in a dose that is higher than the analgesic dose with special concentration on intraventricular hemorrhage, liver function, renal function and blood platelets during treatment but generally the drug is safe one with no serious complications being reported.
    Key words: Paracetamol, acetaminophen, patent ductus arteriosus, premature, preterm, neonate.

    pages:255-263

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  • Article title : Clinico-Epidemiological Aspects of Telogen Effluvium In Iraqi Women
    Description :

    Basman M. Fadheel* MBChB , FIBMS
    Abstract:
    Background: telogen effluvium is a form of non- scarring alopecia characterized by diffuse hair shedding, often of acute onset. It’s a reactive process caused by metabolic or hormonal stress or by medications. Generally, recovery is spontaneous within 6 months.
    Objectives: is to shed a light on the clinic- epidemiological aspects and most important causes of telogen effluvium in Iraqi women.
    Patients and methods: A total number of 100 female patients were seen in the period between March 2014 to March 2015 in the Dermatology Department of Baghdad Teachinhg Hospital / Medical City. Their ages ranged between 20 to 40 years old and the duration of their complaints ranged between 1 to 12 months. Their symptoms were excessive hair loss, diffuse shedding, scalp hair thinning and trichodynia. In all patients the diagnosis was confirmed by positive pull test, and the patients were questioned about all possible triggering factors.
    Results: In most of cases, 74%,the duration of illness was less than 6 months . all the patients complained of diffuse shedding , 12% had visibile scalp thinning and only 8% had trichodynia . In 32% of cases no underlying triggering factor was identified and 21% of cases had acute psychological distress.
    Conclusion: most of cases of telogen effluvium in Iraqi women were without clear underlying triggering factor, most patients were anxious about impending baldness, but significant hair thinning was present in only minority of patients.
    Searching for underlying iron diffeciency is important as 6% of patients had evidence of subcinical iron diffeciency on laboratory examinations.
    Key words: telogen effluvium, triggering factors.

    pages:264-266

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  • Article title : Assessment of Antenatal Care Services regarding Iron deficiency anemia during pregnancy In Sudan - 2010
    Description :

    Ban N. AL- Any* FICMS
    Deyaa AL Deen AL- Saied** MBChB, PhD
    Seeham M. Ubaid BSc, PhD Biology -
    Abstract:
    Background: Pregnancy is a crucial time to promote health thus good antenatal care can promote mother and new born health &links mother with formal health system with increasing chance of using a skilled attendant at birth while inadequate care during this time increases mortality & morbidity of mother & new born.
    Objectives: Assessment of Antenatal Care Services in relation with Iron deficiency anemia during pregnancy.
    Patients and Methods; A descriptive study was carried out in 12 health centers , which were chosen randomly in Behri area (part of Khartoum City) in Sudan that (300) available pregnant females in 3rd trimester were interviewed (using non probability convenience sampling) by using a questionnaire paper during the period between September– December2010.
    Results; The study revealed that most of females were educated & all of their husbands were educated, more than half of them were over thirty & 22% below fifteen , about quarter of them had history of previous abortion & had complications mostly hypertension .The prevalence of anemia was 60% , 40% had mild anemia (mean hemoglobin & S.D 10.18, ±0.51), C.I (10.58 –9.79) , p value <0.05) & 20% had moderate anemia with mean hemoglobin & S.D 7.63 , ± 0.12) ,C.I (7.64- 7.61), p value <0.05). Regarding antenatal care services less than half had taken ferrofole tablet for once & 20% for twice/ day with significant association, P value = 0.001. All of them attended antenatal care centers in the 2nd trimester and mostly for less than 4 visits that mostly affected by education, occupation of females with significance association ,P value = 0.001 , 0.01 respectively & also affected by education of husbands with significant association , P value = 0.001.Regarding dietary pattern most of them had poor intake of white meat , had good intake of carbohydrate unless rice & macaroni . For vegetables more than half had poor intake of green pepper, green leaves, spinach, chard & all of them had poor intake of grape.
    Conclusion; More than half of respondents were anemic ,with high risk pregnancy &still had insufficient coverage & inadequate utilization of antenatal care services which mostly affected by maternal education & occupation , husband’s education & availability with poor spacing between last child & another which affected by parity while for dietary pattern there was average & poor intake of food that rich with iron .
    Key word; Antenatal care services, anemia during pregnancy, risk pregnancy, dietary pattern.

    pages:267-272

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  • Article title : Glycemic control in children and adolescents with type 1 diabetes mellitus in post conflict Iraq: a primary report
    Description :

    Dena M. Kadhim* MBChB
    Eman A. Al-Kaseer* MBChB, FIBMS
    Munib A. Al-Zubaidi** MBChB, FIBMS
    Abstract:
    Background: Type 1 diabetes mellitus (T1DM) is a common disease in childhood. A linear relation between glycemic control (HbA1c < 7) and onset or progression of complication was detected. Only few individuals achieve glycemic control.
    Objective: To estimate the glycemic control among diabetic children attending tertiary center.
    Methods: All diabetic children registered in the diabetic consultancy clinic in Children Welfare Teaching hospital (298) were included in the study. Case records were reviewed and information on demography, weight and height, age at diagnosis and HbA1c was requested.
    Results: Out of the total, 23.8% diabetic children had glycemic control. Glycemic control was decreasing with age (p=0.001), significantly prominent in preschool children (p=0.001), and inversely related with BMI (p=0.03). Sex was not affecting glycemic control.
    Conclusion: Rate of glycemic control was low. It is poorer in those diagnosed in school age, adolescents and obese children.
    Key words: DM, T1DM, glycemic control, Iraq.

    pages:273-275

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  • Article title : Novel methods to design wild bacteriophages into highly lytic and therapeutic bacteriophages to extensively drug-resistant Mycobacterium tuberculosis
    Description :

    Ahmed S. Abdulamir* MBChB, PhD
    Abstract:
    Background: The emergence of multiple drug resistant (MDR) Mycobacterium tuberculosis (M.TB) and extensive drug resistant (XDR) M.TB lay huge burden on TB endemic countries such as Iraq.
    Objectives: Bacteriophage (phage) therapy can be used as alternative approach to tackle this problem. Patients and methods: Forty isolates of M.TB were cultured from TB-positive sputum specimens with three ATCC strains. Phage passaging and biokinetic based techniques were used to optimize wild anti-M.TB phages. Three chemical, non genetic- designing techniques, tween-80, mycobacterial lysis buffer, and xyelen, were used to change the specificity of wild anti-TB phages towards phage-resistant target M.TB.
    Results: Five wild anti-M.TB phages were isolated and optimized. The optimization techniques were successful in enhancing plaques size, clarity, burst size, and infective ratio. Chemical designing techniques succeeded to reorient specificity of 6 phages to new host bacteria.
    Conclusions: phage designing opens door wide for endless future applications of phage-based therapy, biocontrol and diagnosis.
    Keywords: bacteriophage,

    pages:276-282

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  • Article title : Prevalence of Entamoeba Histolytica infection in patients with colitis (Ulcerative and Infective)
    Description :

    Luay I. Farhan Al-Rwi*                  FICMS (Path)
    Maher M. Hassan Alakori*            FICMS (Ped)
    Kifah H. Abdulghafour**               MBChB, PhD (Path)
    Abstract:
    Background: Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon that often extends to involve the remainder of the large intestine in a continuous manner. Intestinal amoebiasis can present as a chronic, dysenteric syndrome of diarrhea, weight loss, and abdominal pain that can last for years and mimic ulcerative colitis.
    Objective: Studying the prevalence of E..histolytica by using serological method ELISA for their detection, Investigate the possible role of E.histolytica as a cause of blood, diarrhea in non-ulcerative colitis group &Comparison between serological detection of E.histolytica and stool examination.
    Patients and Methods: Retrospective and prospective study was conducted on 48 patients (18 males, 30 females); 30 patients were diagnosed as ulcerative colitis and 18 as non ulcerative colitis patients by endoscopy, histopathology, radiology and laboratory examinations at Gastroenterology and Hepatology Teaching Hospital through the period between January 2008 and June 2008.
    From all patients and control, a detailed medical history was taken; routine examination and relevant investigations were done. Blood and fresh stool specimens were collected from all patients and control. General stool examination and ELISA tests for IgG anti E.histolytica antibodies were assessed.
    Results: Histological typing of ulcerative colitis grouped into chronic ulcerative colitis 42 cases(86.67%) and active on chronic ulcerative colitis 6 cases (13.33%). By general stool examination, E.histolytica was positive in (70%) of ulcerative colitis (53.33% cyst and 16.67% trophozoit) and results of ELISA test for IgG anti E.histolytica antibodies was significant compared with control group (P < 0.05). General stool examination and IgG anti- E histolytica antibodies has been found that 75.8% of patients have positive IgG and cyst stage, and 77.8% were have positive IgG and trophozoit stage , while 24.2% of negative GSE results were also negative for IgG anti-E.histolytica antibodies, and the association was significant compared with control group (P < 0.05).
    Conclusion: E.histolytica IgG Abs were significantly higher in ulcerative colitis compared to non ulcerative colitis group .Close association between E.histolytica and ulcerative colitis also there is a high incidence of E.histolytica among group of non ulcerative colitis patients.
    Sensitivity of detection of E.histolytica by ELISA and GSE is rather equal.
    Key Words:,Entameobahistolytica , ulcerative colitis.

    pages:283-288

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  • Article title : Immunohitochemical expression of p53 in human colocrectal carcinoma
    Description :

    Sazan abdulwahab Mirza* FICMS.Path
    Tharwa H. Hassan AL-Tai** BSc,MSc Microbiology
    Hind H. shaker** BSc,MSc Microbiology
    Abstract:
    Background:- Colorectal carcinoma is the most common cancer after the breast cancer in female and bronchus cancer in male. P53 is a tumor suppressor gene, approximately half of colorectal cancers present mutation in p53 gene.
    Objectives:- To determine the frequency and the pattern of p53expression in colorectal carcinoma by immunohistochemical technique and to correlate this expression with different clinicopathological parameters.
    Materials and methods:-Thirty cases of colorectal carcinoma were included in this study, these cases were diagnosed in private pathology laboratories in Baghdad / Iraq from January 2015 to Jaune 2015. Clinicopathological parameters such as age , gender , pathological diagnosis , including the tumor site , lymph nodes status , grade and stage of tumor were taken from patients files.Sections of 4μm stained by hematoxylen and eosin stain and immunohistochemical stained for p53.
    Results: Nineteen (63.3%) of the cases were males, 11(36.7%) cases were females, with age distribution ranging from (39-89) years with a mean age of 56.5 years . Ten cases(33.3%) located in the cecum , 3(10%)cases from each right colon , sigmoid 8 (26.7%) cases were from left colon and 6(20%) cases were from the rectum. Histologically the tumor grade range from moderately differentiated in 27 (90%) cases, and poorly differentiated in 3 (10%) cases. Regarding pathological staging (TNM system),2 (6.7%) cases were T2 ,24 (80%) were T3 , 4(13.3%) cases were T4. Lymph node involvement found in 14(46.7%) cases, and distant metastasis was found in 3(10%) cases. P53 expression was present in 11(36.7 %) cases, were distributed as follows:- weak in 1(3.3%) case,moderat in 3(10%) and marked in 7(23.4%) cases. There was no correlation between p53 expression and the clinicopathological parameters age , sex , histopathological grade, location , lymph nodes status and tumor stage.
    Conclusion: There was no significant statistical correlation between P53 expression by tumor and different clinicopathological parameters in this study.
    Keywords: Colorectal cancer, p53.

    pages:289-292

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  • Article title : Effects of Some Commonly Used COX-1 and COX-2 in the treatment of minor aches on Ovulation in Women A (Clinical Study).
    Description :

    Ahmad M.AL-Zohyri* PhD
    S.S Shihab**. FRCP, MRCP, DMR, CES
    Asmaa N.Abed*** MBChB
    Abstract:
    Background: Ovulation is the central event in ovarian physiology, and ovulatory dysfunction is a relevant cause of female infertility, (NSAIDs) are consistently inhibit ovulation, likely due to the inhibition of cyclooxygenase that is the rate limiting enzyme in prostaglandin (PG) synthesis.
    Objectives: The present study was designed to find out the possible restraining influence of some COX-1 and COX-2 drugs on ovulation in women at the child-bearing age and to warn physician of prescribing them to women who want to conceive.
    Patients and methods:The present study employed in women[52 patients plus 12 controls] attending Baghdad teaching hospital department of rheumatology to assess the influences of some COX-1 and COX-2 NSAIDs [celecoxib, mefenamic acid and ibuprofen on ovulation in women at childbearing age.
    Results:The present study demonstrated a significant inhibition of ovulation in patients treated with celecoxib , ibuprofen & mefenamic acid and Celecoxib was the highest inhibitor of ovulation compared to the other two drugs ( ibuprofen & mefenamic acid ).a non significant decrease in progesterone level in all three groups in compared to the control group,Functional cyst have been observed in patients treated with celecoxib,and no functional cyst occurs in other two groups treated with mefenamic acid and ibuprofen.Endometerial thickness not affected in all three treated groups.
    Conclusion: The above findings should be kept in mind and taken in consideration by physicians when they prescribe NSAIDs[Celecoxib,Ibuprofen &mefenamic acid ] to treat female patients at childbearing age due to the inhibitory effects of these drugs on ovulation.
    Keywords: NSAIDs and Infertility,leutinized unruptured follicle,NSAIDs and functional cysts.

    pages:293-297

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  • Article title : Serological Patterns of Hepstitis B Virus Among HBsAg Negative Blood Donors in Baghdad, Iraq by Using Architect System
    Description :

    Zainab S. Hassab* BSc. MSc
    Amani K. Abd Al-Ruhman** BSc, MSc
    Yakub A. Saleh** BSc, MSc. PhD
    Auroba, I. Abd Allah** BSc, MSc
    Abstract:
    Background: About 10-15% of population HBV infection becomes chronic, and 85-90% are resolved. In Iraq, HBs-Ag assay by ELISA is only mandatory test for detection of HBV infection in blood donors. Anti-HBc and anti-HBs were not detectable in their sera.
    Objective: To investigate the distribution of serological patterns for HBV who were HBsAg negative.
    Material and method: Between July 18, 2011 to December 25, 2011, 10ml of blood samples were collected from National blood Transfusion Center donors, Baghdad, for 25782 individuals (25294 male, 488 female), mean age (20-65)years. HbsAg positive sera excluded (185), and final number of donors included in the study was 25597 HbsAg negative.
    Result: The data showed a previous exposure for HBV(p>0.05) through anti-HBc and anti-HBs 3.8% by Architect system. The anti-HBs combine with anti-HBc was 68.5%, while anti-HBc alone was 31.5%. Independent risk factors were association with married, history of blood transfusion and residence.
    Conclusion: The prevalence of the HBV in Iraq is 4.6% as intermediate region at first time.
    Key Words: Serological patterns, HBsAg negative,Architect system,Blood donors.

    pages:298-302

    File size : 507 KB
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