Home | Journal Issues | Vol.57. Issue , No. : 3. , 2015

Vol.57. Issue , No. : 3. , 2015

Published: 1/10/2015 – Start page -183  , End Page -262


  • Article title : Delayed Recovery of Contrast Induced Kidney Injury Post Angiography: Rate and Risk Factors
    Description :

    Hilal B. Al-Saffar              CABM, FRCP,(Lond.,Edin), FACC

    Adel J. Yassin**                               Dm, Dm (int.cardiology)

    Ala Ali***                                 FIBMS(int.med.), FIBMS(nephro)



    Background: Exposure to Contrast media is the third leading cause of hospital acquired acute kidney injury. It follows a predictable time of onset and a less predictable scenario in recovery. This is related to certain factors, but at the end there will be asubstantial association with increased mortality, morbidity, and length of hospitalization.

    Objectives: To define the Incidence of persistent contrast induced renal impairment a month after angiography and to define the risk factors for such persistence

    Patients and Methods: One hundred and one patients (101) were enrolled in this study. All were referred to the Iraqi Center for Heart Diseases in Baghdad/ Iraq for coronary and/or peripheral vascular angiography from October 2009 to July 2010. All patients’ clinical and laboratory data including baseline renal function tests were ordered and recorded with subsequent risk categorization. Post procedure serum creatinine checked on regular intervals (48 hours, one week, and then weekly for three months for those with serum creatinine consistent with the contrast induced - acute kidney injury (CI-AKI) definition at 48 hours.

    Results: The mean age for the study group was 62±16.9 with 78 (77%) male. Twenty three patients (22.7%) had diabetes mellitus. Thirteen patients (12.7%)had a pre-existing renal impairment. Twenty one patients (20.7%) received extradoses of contrast. Thirty two patients (31.6%) developed CIN by the definition within 48 hours of the procedure with the mean serum creatinine of 1.8 mg/dl. Seven patients (6.8%) continued to have impaired renal function at week 4 and persisted to have such low GFR up to three months of the procedure. Baseline low GFR, Diabetes mellitus and extradoses of contrast were independent risk factors for the occurrence of CIN and delayed renal recovery.

    Conclusion: The risk of poor renal recovery after contrast cannot be overlooked. Preexisting renal function impairment, diabetes mellitus, and extra doses of contrast media are independent risk factors for such delay.

    Key Words: Contrast media, Nephrotoxicity, AKI, Angiography.

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  • Article title : Serum Cystatin C as a Predictor of Acute Kidney Transplant Rejection
    Description :

    Fadhil B. Shamkhi*                        MSc

    Ala Sh. Ali*                                      FIBMS

    Hedef D. El-Yassin**                       BSc, PhD, MRSC



    Background: Accurate and rapid assessment of allograft function is essential. Cystatin C has recently been proposed as an alternative marker of glomerular filtration rate (GFR). Its diagnostic value for the longitudinal assessment of graft function has not been addressed well.

    Objective: To study the validity of cystatin C as an early marker and predictor of acute transplant rejection in the first week post transplantation.

    Subjects and Methods: Sixty six renal transplants recipients recruited. The study conducted in four renal transplantation centers in Baghdad for the period from September to December 2011. Serum creatinine and cystatin C concentrations measured 48 hours before transplantation and day 3 and 7 post transplantation.

    Results: Serum Cystatin C observed to significantly increased at day 3 (p<0.0001) and still increased at day 7   in the   rejection. On day 3 areas under the receiver operating characteristic (ROC) curves were 0.749 for creatinine and 0.909 for cystatin C.

    In patients with acute rejection, serum cystatin C level elevated earlier than serum creatinine.

    Conclusion: Serum cystatin C seems to be a valuable marker of renal function in the first week post transplantation.

    Key words: Cystatin C, Renal Transplantation, Acute Rejection

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  • Article title : Congenital pouch colon: A rare presentation of Anorectal malformation  
    Description :

     Salah S. Mahmood*                         FIBMS

    Ahmad Z. Zain**                             FIBMS

    Raghad J. Aboalhab***                  FIBMS



    Background: Congenital pouch colon is an usual abnormality associated with anorectal malformation in which the colon is partially or totally replaced by a pouch like dilatation connected to the genitourinary tract by a fistula(colovesical).The condition varies from complete absence of normal colon with the ileum opening into colonic pouch to the presence of nearly normal colon with only the rectum or recto sigmoid being attached to a pouch which in turn connected to bladder by a band or fistula.

    Objective: is to evaluate the methods of diagnosis and management of(C.P.C) with studying environmental factors especially pesticides and its prevalence.

    Patients and Methods: A total number of seven cases of(C.P.C) associated with high type of imperforate anus seen in Al-Emamain Al-Kadhemain Medical City and Al-Kadhemia Pediatric Hospital from October 2004  to  October 2014.

    Results: Incidence of (C.P.C) was ( 2.9%) of all cases of high type of imperforate anus with male predominant ( 2.5:1).Most of patients were from Baghdad's periphery with suspicioun of relationship of pesticides and its prevalence.Preoperative erect abdominal X-ray was diagnostic in (71%) especially type I and II .The most common type of (C.P.C)was type (II) (34%) followed by type (I) (28%). Abdomino-perineal pull-through and anoplasty were performed at mean age sixth month for most patients with resection or tabularizing of the pouch.Fecal continence was( 8o%) .

    Conclusions:  Erect abdominal X-ray have to be done routinely for every case of high type ARM  in order not to miss any case of (C.P.C).It is better to excise the pouch completely whatever type was because histopathological exam of the pouch revealed abnormal muscle coat with failure to produce propulsive movement.

    Key Words: Congenital pouch colon, Anorectal malformation.

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  • Article title : Single Burr Hole Craniostomy in surgical treatment of chronic subdural hematoma (Outcome and Complications)  
    Description :

    Ali T. AbdulWahid*   MBChB, FIBMS


    Abstract :

    Background: There is controversy among neurosurgeons whether double Burr Hole craniostomy is better than single Burr Hole, craniostomy in the management of chronic subdural hematoma in terms of lower recurrence rate and complications.

    Objective: To assess the outcome and complications including revision rate using Single Burr Hole Craniostomy in the treatment of chronic subdural hematoma (CSDH). 

    Patients and Methods: This is a retrospective study of 42 cases of chronic subdural hematoma who underwent Single Burr Hole Craniostomy(SBHC) from jan.2012 to jan.2014, preoperative,intraoperative and postoperative data were collected including neurological status ,Brain CT-scan findings, postoperative complications ,recurrent rate and neurological deficit. 

    Results: Forty two patients (36 male and 6 female, with age ranged between 60y.-82y.) were treated by Single Burr Hole Craniostomy for chronic subdural hematoma. There were two recurrences, one stroke, and one death after primary surgery. The two recurrent cases were treated by drainage through same Burr Hole and both they did well (recovered uneventfully).

    Conclusions: The results of this study suggest that Single Burr Hole Craniostomy is safe, simple and effective method for surgical management of CSDH with lower recurrence rate and lower morbidity and mortality. 

    Key Words: Chronic subdural hematoma (CSDH), Single Burr Hole Craniostomy (SBHC), complications.                                     

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  • Article title : Bladder exstrophy closure using anterior pelvic osteotomy of superior pubic rami
    Description :

    Moaied A. Hassan                             FICMS, DMAS



    Background: Bladder exstrophy is a rare and complex urogenital malformation. The current surgical approach consists of early closure followed by other procedures later on aiming for continence. Primary closure usually requires some form of osteotomy to facilitate successful bladder and abdominal wall repair. For decades, bilateral posterior iliac osteotomy has been the most commonly used technique. A new osteotomy technique, consisting of anterior pelvic ostecotomy of the superior pubic ramus, seems to be a safe and quick alternative method to obtain tension-free approximation of the symphysis pubis

    Patients and methods: A prospective study between 2006 and 2013, were 10 (9 males and 1 female) newborns underwent surgery for bladder exstrophy closure in the pediatric surgery department, using anterior pelvic osteotomy of superior pubic rami to achieve tension-free approximation of the symphysis pubis and successful repair.

    Results: Successful closure was achieved in 90% of the patients operated upon. Only 1 patient had wound dehiscence and failure of the repair. The procedure was safe, quick with minimal blood loss and was performed by the pediatric surgeon without the need to an orthopedic surgeon.  

    Conclusion: Anterior pelvic osteotomy of superior pubic rami in an effective alternative measure to obtain tension-free approximation of the symphysis pubis, and hence successful bladder exstrophy repair. It provides further advantages namely, ease and rapidity, minimal blood loss, and no requirement for an extra skin incision or patient's repositioning.         

    Keywords:-Bladder exstrophy, closure, pelvic osteotomy, superior pubic rami.

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  • Article title : The role of computed tomography in intra-axial posterior fossa tumors
    Description :

    Ali I.  Sheaa*                   MBChB, CABMS- RAD

    Mohammed Al-Hili*        DMRD, FICMS                              

    Ali K. Al-Shalchy**        MBChB, FIBMS,MRCS, FRCS



    Background: CT (computed tomography) is one of the first noninvasive imaging techniques in diagnosis of intra-axial posterior fossa tumors because it can accurately demonstrate, localize and characterize brain tumors, and can provide important information about the anatomic location, size, shape of the lesions and their mass effect on adjacent structures.

    Objectives: To evaluate multi detectors CT characteristics of intra axial posterior fossa tumors and correlation of the CT characteristics of intra- axial posterior fossa tumors with the histopathological findings.

    Patients & Methods:  This is a cross sectional study including 26 patients with intra-axial posterior fossa tumors,15 males &11 females ,three cases were excluded from the study because no definite histological diagnosis was done so the final included number was 23 cases .The cases were referred from the Department of Neurosurgery in Ghazi Al-Hariri specialized surgical hospital in Medical city complex at the period between January 2012 to January 2013.

    Results: The most common intra- axial posterior fossa tumors were astrocytoma, and medulloblastoma (26.1%)   for both equally. These tumors are more common in pediatric age group (60.9%) than adult (39.1%). Medulloblastoma was the most common childhood tumors. Hemangioblastoma and metastasis were the most common adulthood tumors. The gender distribution of the total number of patients showed male predominance by a factor 1.5, (60.9%) were males, and (39.1%) were females.

     CT scan was sensitive in detection of tumors but it was not specific to give the definite histopathalogical tumors type.

    Conclusion: Medulloblastoma and astrocytoma were the most common intra axial posterior fossa tumos. The gender distribution showed male predominance. CT scan was sensitive in detection of tumors but it was not specific to give the definite histopathalogical tumors type. The confidence interval of CT in diagnosis of histopathlogical types is 65.2 % but it is still useful in the detection, localization and characterization of tumors.

    Key words: intra axial, posterior fossa, tumors, multi detectors CT.

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  • Article title : Treatment of perniosis with oral tadalafil, pentoxifylline or prednisolone A therapeutic comparative study  
    Description :

    Khalifa E. sharquie *         PhD

    Husam A. Salman *           FIBMS

    Adil A. Noaimi *                FICMS



    Background: perniosis is a common dermatological problem. Different modalities of treatment are available with conflicting results and no single effective therapy is universally accepted.

    Objective: To evaluate the effectiveness of oral tadalafil and compare it with pentoxyfylline or prednisolone in treatment of perniosis

    Patients and methods: This was a therapeutic comparative trial conducted in the department of Dermatology, Baghdad Teaching hospital, Baghdad, Iraq between November 2011 and March 2014.

    Fifty eight patients with perniosis were enrolled in this study, and divided into 3 groups. Group (A) comprised 19 patients who received oral tadalafil (5 mg once daily); group (B) comprised 18 patients who received pentoxifylline tablet (400 mg three times daily) and group (C) included 21 patients who received prednisolone 15 mg twice daily. The treatment duration was 2 weeks. All patients did not receive any treatment before the study. A severity score was proposed taken in consideration the number of finger/ toes, type of lesion, coldness, cyanosis and itching

    Results: Forty seven patients completed the study. Their ages ranged from 13-43 with a mean ± SD of 22.38 ±6.99 years. Thirty three patients were females (70.21%) and 14 were males (29.79%).

    The percentage of improvement was 50.65, 44.16 and 31.51% for the groups A, B and C respectively.

    Conclusion: Tadalafil has a superior effect over pentoxyfylline. The latter has a better effect than prednisolone. 

    Key words: Tadalafil, pentoxifylline, prednisolone, perniosis, chilblains

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  • Article title : The value of computerized tomography of the chest in patients with neutropenic fever
    Description :

     Khudhair A AL-Khalissi *                            MRCP (UK)

    Ahmed I Shukr **                                        FIBMS FICM Haem

    Azher S AL-Zubaidy***                                  CABM



    Background: Absolute neutropenia in hematological malignancies remains the single most important risk factor for infection, which can be fatal and requires urgent management including radiological procedures and treatment.

    Objectives: To compare computerized tomography (CT) of the chest with chest radiology (CXR) in the assessment of febrile neutropenic patients with hematologic malignancy.

     Patients and methods: A prospective study, carried out in the hematological ward, Baghdad teaching hospital, for the period from 1stApril 2011to 30thApril 2012.It included 46 neutropenic febrile patients .All had chest X-ray (CXR) and computerized tomography (CT) of the chest.

    Results: Male were 21, and female were 25. Mean age was 47.89 ± 15.32 years. Mean absolute neutrophil count (ANC) was 0.25X109/L. 29 (63%) patients had normal CXR in which CT was abnormal in 3 of them. 17 (37%) had the same abnormalities on CXR and CT.

    Conclusion: Computerized tomography is superior to CXR in patients with neutropenic fever, and it should be included in the investigations, especially in patients with respiratory symptoms.

    Key words: Chest radiography, Computerized tomography, Neutropenic fever.

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  • Article title : Exposure to violence and academic achievement in Iraq
    Description :

    Nesif J. Al-Hemiary*       MBChB, FIBMS (Psych)


    Background: Iraqis were exposed to wars, widespread violence and civil war. Post-traumatic stress disorder develops after exposure to trauma and violence. It has a negative effect on academic achievement of the students.

    Objective: This report was carried out to study the effect of exposure to violence on academic achievement of youths in Iraq.

    Methods: A total of 319 university students from Baghdad were included in the study. Their age ranged between 18 and 24 years with male to female ratio of 0.6:1. A questionnaire was filled for each participant. Requested data were demographic information, data on school achievement and Harvard Trauma questionnaire (exposure to war trauma, posttraumatic stress disorder "PTSD"). Chi square was used to examine the association between PTSD and poor academic achievement. Student’s t test was used to demonstrate the difference in exposure between students with poor and good academic achievement. P value < 0.5 was considered as significant.

    Results: Post- traumatic stress disorder was observed in 21.9% of students. Poor academic achievement was noticed in 32.9% of students with post-traumatic stress disorder. Academic achievement was not significantly associated with post-traumatic stress disorder (p=0.8). Significant difference was found in score of exposure to violence between students with poor and good academic achievement (p= 0.001).

    Conclusion: Exposure to violence had a negative effect on academic achievement

    Key words: violence, exposure, post traumatic stress disorder, academic achievement.

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  • Article title : Bullying victimization among school- going adolescents in Iraq
    Description :

    Hyder M. Yahya *                        MB ChB

    Mushtaq T. Hashim**                 MB ChB, CABPsych

    Eman A. Al-Kaseer *                    MB ChB, FIBMS

    Jawad K. Al-Diwan *                   MB ChB, MSc, FIBMS



    Background: Bullying victimization is a major public health problem. Interest in bullying in Arab world is a recent phenomenon. Publication on victimization in Iraq is scares. Therefore this study was conducted to report bullying among students of Iraqi schools.

    Methods: A total of 302 students from Baghdad was selected by a cluster random sample to include in this study. An Arabic version of standardized questionnaire was obtained from the International (ISPCAN). Identification of bullying (bullies, victims and sexual victims) was done by using a cutoff  for the scoring of bullying manifestation in the questionnaire depending on three repeated action at least to consider as bullies. P value less than 0.05 was considered significant for meeting the criteria of bullying.

    Results: Out of the total 39.1% were bullied pupils (victims) there was a significant association between bullying and victim with sex (P=0.001). Bullying and victimization was significantly associated with smoking, drug abuse, and failure in school (P=0.001 for each).

    Conclusion: High prevalence of victimization (bully, victims and sexual victim was revealed among students in schools as a predictor for smoking and drug abuse.

    Keywords: Bullying, victimization, sexual victim, Iraq.

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  • Article title : Prevalence of BRCA1 Oncogen Expression in Breast Cancer Specimens of Patients with Positive Family History
    Description :

    Wijdan. H.Al- Dabbagh*         MBChB

    Nada.A.S.Al- Alwan**             PhD (Path)

    Salim R. Al-Ubaidy***            PhD (Path)



    Background: Breast cancer is the leading female cancer worldwide and in Iraq .Some mutations, particularly in BRCA1, significantly increase the risk of the disease.

    Objectives: To demonstrate the frequency of BRCA1 in a group of high risk women with “positive family history’’ of breast cancer; correlating the immune expression of BRCA1 with some parameters of known prognostic significance.

    Patients and Methods: Eighty-two female patients diagnosed with breast cancer (50 familial and 32 non familial) were included in the study .The mean age of the patients was 48.07. Immunohistochemistry was performed to assess the BRCA1 oncogene expression, Estrogen Receptor (ER), Progesterone Receptor (PR), Her 2 neu contents of the tumors.

    Results: Out of the study group, 60.9% revealed family history of breast cancer. Forty-eight percent of the patients with positive family history were in the age group of 45 years or below; of those, 42.9% gave family history of cancer in their first degree relative while 25.7% had second degree relatives.  BRCA1 positive expression was demonstrated in 39.02% out of all patients with breast carcinoma. In patients with positive family history for breast carcinoma, BRCA1 positive expression was demonstrated in 54% while in patients with negative family history it was 15.6%.  Among patients with positive BRCA1 expression 71.9% of those had negative ER expression and 57.9% exhibited negative PR expression.

    Conclusions: BRCA1 gene expression determination in patients with positive family history should be promoted and validated to serve as indicators for early diagnosis of the disease.

    Keywords: Breast, Cancer, BRCA1, ER, PR, Her2 neu, family history.

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  • Article title : Antibodies to selected minor target anti-neutrophil cytoplasmic antigens in systemic lupus patients
    Description :

    Nahla G. abdul-Majeed*           MBChB, FIBM  immunology



    Background: Anti-neutrophil cytoplasmic antibodies (ANCA)minor subsets (elastase , lysozyme , cathepsin G , lactoferrin & BPI )are detected among systemic lupus erythromatus patients causing vasculitis. Systemic lupus erythematosus (SLE) is the prototypic immune complex disease, characterized by excessive autoantibody production, immune complex formation and immunologically mediated tissue injury.

    Methods& Patients: A cross-sectional study was conducted on two main groups ,74 patients with SLE and 30 apperantly healthy control volunteers referred to immunology department in teaching laboratories \ medical city during period of  (1st of march – 31st of May) 2011. Antinuclear antibody (ANA) ,Cathepsin G, elastase,  lactoferrin, lysozyme, bactericidal permeability increasing protein and C1q were detected by enzyme-linked immunosorbent assay (ELISA) technique. While dsDNA was detected by indirect immunofluorescent(IIF) technique and C3,C4 by single radial immunodiffusion (SRID ) .

    Result: Among patients group the mean levels of Cathepsin G (9.19 IU/ml), Elastase( 8.46 IU/ml) , Lysozyme (6.81 IU/ml), Lactoferrin (9.2 IU/ml)and BPI (5.59 IU/ml). Among positive ANA result cathepsin G was detected in high percent (35.1%). In regard to dsDNA positive result elastase Ab was detected in 18 (46.3%) with significant P value 0.00,while Cathepsin G (47.4%) & lactoferrin Ab(31.6%)were significantly found among C1q positive patients .Interestingly  lactoferrin Ab associated with low complement C3&C4 levels .

    Conclusion Anti-neutrophil cytoplasmic antibody has a role among SLE patients in which cathepsin G detected in 35.1% among ANA positive patients ,while elastase & cathepsin G,significantly associated with disease activity (positive dsDNA,C1q) ,on other hand lactoferrin had a significant results in association with renal involvement (low C3,C4 levels ).

                  Key word: SLE, cathepsin G, elastase , lysozyme , lactoferrin & BPI

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  • Article title : Validity of serum galectin-4(Gal-4) in diagnosis of gastric adenocarcinoma:
    Description :

    Aida R. Al-Derzi *                 MBChB, MSc, FICMs/Path     

    Hind H. Al-Ammiri**           BVM&S, MSC, IMMUNOLOGY

    Nahla Ghanim***                  MBChB, FICMS/ Path  



    Background:  Galectin-4 is one of  a b-galactosides binding proteins family that recognize a variety of glycan -containing proteins at the cell surface and are overexpressed in various tumors, including gastric cancer. Galectin-4 overexpression as well as changes in their subcellular distribution has been associated with gastric cancer progression and poor prognosis. It may provide diagnostic molecular markers for gastric cancer as well as clues for developing therapeutic targets on individual basis.

    Objectives : The aims of the present study were to determine the levels of GAL-4in the sera of healthy people and patients with gastric cancer and also, to investigate the validity of using GAL-4 as a specific diagnostic marker of gastric cancer.

    Patients and methods: twenty five gastric cancer patients were included in this study. They were among patients who attending the Endoscopy Department in Baghdad Medical City Teaching Hospital, during the period from December 2011 to July 2012. In addition, fifteen apparently healthy person were chosen as a healthy control group. For these two groups, serum level of GAL-4 using sandwich ELISA technique was carried out.

    Results: There was a statistically significant difference in serum level of GAL-4 among gastric adenocarcinoma patients in comparison to healthy controls (p≤0.001), using receiver operating characteristic curve (ROC) area, serum GAL-4 has high area under the curve (0.924) with a cut off value equal to or above 0.42ng/ml which was associated with the highest sensitivity (100%).

    Conclusions: The current study showed that serum levels of GAL-4 were significantly higher in patients with malignant gastric adenocarcinoma which may confirm a possible role of this marker in the pathogenesis of the disease, furthermore the highest sensitivity and best accuracy obtained from serum GAL-4 was by using a cut off values equal to or above 0.42ng/ml; Therefore, GAL-4 may be promising new diagnostic tools especially at early stages and among patients at high risk.

    Key words: galectin-4, gastric cancer, validity.

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  • Article title : Development of Anti-bodies against Infliximab in Iraqi Patients with Rheumatoid Arthritis.  
    Description :


    Mohammed A.Al-Karkhi*             MBChB, MSc, PhD

    MuhammedM.Al-Ani*                   MBChB, MSc, FICMS

    NizarA.Jassim**                              FICMS

    BatoolM.Mahdi***                         MBChB, MSc, FICMS

    Layth abd-alailah****                    MBChB,FICMS



    Background: Rheumatoid arthritis is a common chronic and destructive autoimmune arthropathy .Treatment with infliximab gives great improvement to a large numbers of patients with RA ,however, in some patients after prolonged treatment infliximab can induce anti-infliximab antibodies formation and result to loss of infliximab efficacy and active persistent disease.

    Objective: to investigate the frequency of anti-infliximab antibodies  in Iraqi patients with rheumatoid arthritis .

    Patients and methods: fifty Iraqi RA patients(36 females and 14 males) compared with 50 control( 25 healthy control and 25 case control (patients  with RA on other treatment) ) were included in this study from begging of  March 2014 till   end of September 2014.All patients were diagnosed by full history, complete clinical examination and laboratory test. Anti-infliximab antibodies were meatured using enzyme-linked immunosorbent assay in serum of Iraqi patients with RA treated with infliximab more than 3 months duration.  

    Results: Antibodies to infliximab were detected in 35(70%) Iraqi RA patients , while the patients without detectable antibodies against infliximab were 15(30%),also there were no anti-infliximab antibodies in the control groups.

    Conclusion: In this study, nearly three quarter of the Iraqi RA patients treated with infliximab developed anti-infliximab antibodies.

    Key words: rheumatoid arthritis, infliximab, anti-infliximab antibodies

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  • Article title : Expression of CD69 molecule in Iraqi patients with Rheumatoid Arthritis
    Description :


    Hayfaa S. AL-Hadithi*       FICM/path



    Background: Rheumatoid arthritis (RA) is an autoimmune disease where the body's immune system attacks normal joint tissues, causing inflammation of the joint lining. Cluster of Differentiation 69 (CD69) is a human transmembrane C-Type lectin protein encoded by the CD69 gene. The activation of T lymphocytes and Natural Killer (NK) Cells, both in vivo and in vitro, induces expression of CD69. The early activation antigen CD69 has been implicated in the pathogenesis of some inflammatory diseases, therefore its expression on peripheral blood T-lymphocytes must be evaluated.

    Objective: To evaluate the expression of CD69 on peripheral blood T-lymphocytes in RA Iraqi patients.

    Patients and methods: This prospective study was carried out in the period between March 2014 and May 2014. The study involved 40 patients diagnosed with RA attending rheumatology outpatient's clinic Baghdad medical city teaching hospital and 40 apparently healthy individuals as a control group. Erythrocyte sedimentation rate (ESR) was measured by Westergren method. Flow cytometric immunophenotype analysis applied on T-lymphocytes for measuring the fluorescence intensity of CD3 and CD69 expression on those cells.

    Results: This study showed that the mean of ESR in RA patients was (66.8) while in healthy control it is only (20.4). And the mean of CD3 was higher in healthy individuals (41.88) than in RA patients (35.32), while the mean of CD69 was significantly higher among RA patients (11.09) than that of healthy controls (3.58). Also a moderately strong positive linear correlation was found between CD69 expression and RA severity.

    Conclusions: the expression of CD69 was up-regulated in freshly isolated peripheral blood lymphocytes from RA patients in comparison to healthy individuals.

    Keywords: Rheumatoid arthritis, CD69

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  • Article title : Biochemical studies on the effect of Crataegus aqueous extract on oxidative stress during  ischemia/reperfusion induced myocardial injuries
    Description :

    Mustafa T. Mohammed*             Bsc, Msc, PhD (Biochemistry)



    Background: myocardial ischemia-reperfusion (I/R) injury may occur in a variety of clinical set­tings and this remains a significant problem. Oxygen free radi­cals, produced on reperfusion have been shown to play a major role in myocardial I/R injury. Various therapeutic effects have been described for Crataegus. Additionally, it has been presented that Crataegus has protective effect against ischemia reperfusion induced myocardial injuries to various organs. Therefore, it seems possible that the administration of Crataegus might protect the heart against the ischemia reperfusion  injury.

    Objectives: I detected the chemical components and trace elements of the aqueous extract of Crataegus leaves and determine whether Crataegus extract prevents or decreases ischemia-reperfusion induced myocardial injuries in rats.

    Methods: The chemical composition of the aqueous extracts of the Crataegus leaves was analysed and concentration of some trace elements was estimated .Thirty-six rats were divided into three groups as control, I/R group and Crataegus treatment group. Blood samples were taken from the rats for the biochemical parameters estimating, serum aspartate aminotransfera­se (AST), alanine aminotransferase (ALT),  lactate dehydrogenase (LDH)  oxidative stress  levels of nitric oxide (NO) and lipid peroxida­tion (LPO).

    Results: The results showed that the extract contain: glycosides saponins, tannins ,phenolic compounds , proteins  and flavonoids . The results also showed that there were high concentrations of K , Na , Ca with (171.2 , 19 , 18.3)  ppm, respectively and low concentrations of  Fe, Zn ,Cu, Mg with (5.1, 3.2 ,2.3 ,1.9)  ppm, respectively ,very low concentrations Cr ,Cd , Pb  with (0.9 ,0.7, Nil) ppm . The levels of heart enzymes and Oxidative stress in group 3 were significantly lower than those in the group 2.Our results suggest that Crataegus treatment protects the rat heart against ischemia-reperfusion induced myocardial injuries.

    Conclusion: The present study confirms that the aqueous extract of Crataegus contains (glycosides, tannins, proteins, saponins, phenolic compounds and flavonoids) as well as our results suggest that Crataegus treatment protects the rat heart against ischemia-reperfusion induced myocardial injuries .

    Key words: Crataegus,   ischemia/reperfusion ,myocardial injuries

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  • Article title : Effect of 1,3-Oxazepine Derivative on Alkaline Phosphatase and Lactate Dehydrogenase Activity in Healthy Iraqi Females Serum
    Description :

    Warka’a T. AL-Sa’adi*                 PhD

    Anwar F. Al-Tai*                          PhD

    Hasan H. Al-Saeed**                    PhD

    Ali K. Mahmood*                         PhD



    Background: Heterocyclic compounds and its derivatives have biological activities and used as analgesic, anti-helminthic, antituberculer, antifungal, antiviral, anticancer and inhibitor of some enzymes. Oxazepine (benzodiazepine) derivative used in relief of psychoneuroses characterized by anxiety and tension. Alkaline phosphatase (ALP) hydrolyzes phosphate monoesters, while Lactate dehydrogenase (LDH) catalyses oxidation of L-lactate to pyruvate utilizing NAD+      

    Objective: The study was carried out to know of the impact of 1,3-oxazepine derivative on the ALP and LDH enzyme activity on human serum in vitro.

    Methods: The study included the effect of synthesized 1,3-oxazepine divertive [(Z)-3-(5-mercapto-1-3,4-Thiadizol-2-yl)-2-(4-nitrophenyl)-2,3-dihydro-1,3-oxzepine-4,7-dione] on the activity of enzymes ALP and LDH for (34) healthy Iraqi females serum in vitro. The activity of both enzymes was measured spectrophotometrically. Different concentrations of 1,3-oxazepine derivative were used and the inhibition percentage was calculated.

    Results: The results of this study revealed that effect of 1,3-oxazepine derivative was inhibitor for ALP and LDH activity and the high inhibition percentage was 87.56% for ALP. The high inhibition percentage was 50% for LDH when 1,3-oxazepine derivative was used.

    Conclusions: 1,3-oxazepine derivative affected as inhibitor on ALP and LDH enzyme activity in human serum in vitro. This can be used in drug industry in the future.

    Key wards: Alkaline phosphatase, Lactate dehydrogenase, 1,3-oxazepine derivative.

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  • Article title : Serum Osteocalcin and Serum Osteopontin Levels in Osteoporotic Postmenopausal Women with and without Vertebral Fractures
    Description :

    Nawar S. Mohammed*                              MSc

    Kisma M. Turki*                                    PhD

    Mohammed H. Munshed*                     CABM, FIBMS (Rheum & Med Rehab)



    Background: Osteoporosis is a progressive systemic skeletal disorder characterized by low bone mass and micro-architectural deterioration of bone tissue spatially in postmenopausal women and its major complication fractures.

    Objective: The aim of this study was to find out the significance of serum OC and serum OPN levels with the incidence of osteoporosis and its major complication (fractures).

    Patients and Methods: Eighty-five postmenopausal women (PMW) whose ages were fifty years and over categorized into three groups: osteoporosis PMW without VFs (n=30), osteoporosis PMW with VFs (n=28), and healthy PMW (n=27). Sera samples were analyzed for alkaline phosphatase, calcium and phosphorous by using spectrophotometric kit. Serum OC and serum OPN levels were measured by ELISA kits.

    Results: Bone Mineral Density (BMD) and T-score were significantly lower in osteoporotic PMW with and without VFs as compared with healthy PMW (p=0.0001, p=0.0001, respectively). Serum OC levels and serum OPN levels were elevated significantly in osteoporotic PMW with and without VFs as compared with healthy PMW (p=0.0001, p=0.0001, respectively), the levels of serum OC and OPN showed a significant positive correlation with age  in osteoporotic PMW. There is a significant positive correlation between serum OC levels and serum OPN levels in osteoporotic PMW and non-significant correlation was found in healthy PMW.

    Conclusion: The levels of serum OC and OPN can be used as a biochemical indicator in the diagnosis of postmenopausal osteoporotic women. 

    Keywords:  Postmenopausal, Osteoporosis, Vertebral Fractures, Osteocalcin, Osteopontin

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