Home | Journal Issues | Vol.58. Issue , No. : 2. , 2016
58-2

Vol.58. Issue , No. : 2. , 2016

Published: 1/7/2016 – Start page -104  , End Page -19



articles...


  • Article title : Comparative study of two different techniques for leak and bleeding prevention during laparoscopic sleeve gastrectomy
    Description :
    دراسة مقارنة بن اثنين من تقنيات عملية قص وتكميم المعدة بالناظور للحد من التسرب والنزف

     

    Ramiz S.  Mukhtar*     FRCS

    Abstract:

    Background: Laparoscopic sleeve gastrectomy has gained more popularity as an independent bariatric procedure because laparoscopic sleeve gastrectomy was reported to be an effective, safe, and time-saving procedure, leading to adequate weight loss for morbidly obese patientsand becoming one of the most common procedures performed for the treatment of morbidly obese patients in the last few years until now.

    Objectives:The aim of this study is to compare two different techniques of the reinforcement of staple line during LSG in the reduction of major complications (bleeding and leak).

    Patients and methods:prospective randomized study of a consecutive series of 126 patients that underwent LSGbetween April 2014 till August 2015. Patients were randomly enrolled in two different techniques of reinforcing the staple line during LSG, Group A consisted of 63 patients that underwent sleeve gastrectomy using Ethicon Endo GIA stapleTM with staple line oversewn using 2.0 prolene continuous suture, group B also 63 patients who had the staple-line oversewn with a continuous suture using V-locTMand Covidien Endo GIA tristapleTM.
    Results:126 patients who underwent LSG, 82(65%) were women and 44(35%) were men. Median age was 36 years (range, 19–58 years) and median preoperative BMI was 45.4 kg/m2 (range, 37–62 kg/m2), Three  patients (4.76%)from group (A) and 2 patients (3.17%)from group (B)developed primary  hemorrhage (within the first 24 hours post operatively), overall bleeding rate in both groups was (3.96%), no leak in both groups and no mortality.
    Conclusion:laparoscopic sleeve gastrectomy is a safe procedure as a sole weight reduction operation. The combination of meticulous surgical technique, reinforcement of the gastric staple line, lead to decrease the incidence of staple line leak whatever the suture material or stapler type used, but there is no significant decrease in the incidence of bleeding with staple line reinforcement.

    Keywords:sleeve gastrectomy, staple line reinforcement, leak, bleeding.

    P.P.:104-108

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  • Article title : Laparoscopic cholecystectomy with harmonic scalpel
    Description :
    رفع المراره بالناظور بأستخدام المشرط التوافقي

    Tariq Ibrahim al-aubiadi*          MBChB,FIBMS

    Waleedabdul H. Salman**         MBChB, FIBMS

    HasanF. Azeez***                      MBChB, FIBMS

     

    Abstract

    Background:The Harmonic scalpel (HS) has been proven to be an effective, efficient, and safe instrument for dissection and hemostasis in both open and laparoscopic surgical procedures. The primary use of the HS in laparoscopic cholecystectomy (LC) has been for the division of the cystic artery and liver bed dissection. Advancements in the Harmonic scalpel blade tip now provide for the reliable ultrasonic division and closure of the cystic duct.

    Objectives:This study was planned to compare the clips and cautery (CC) method of laparoscopic cholecystectomy (LC) versus LC using HS as regard to the safety and efficacy for symptomatic gallstone disease.

    Patients and methods:This is a prospective study conducted in Baghdad Teaching Hospital/ 1st Surgical Unitat the Medical City, done on (120) patients within the period between1st October 2010 and 1st October 2011 who underwent LCfor symptomatic gallstone disease. These patients have been classified into two groups Group A included 60 patientswho underwentthe (CC) method, and Group B included60 patients done by (HS) method. The intraoperative and postoperative parameters were collected including duration ofoperation, intraoperative blood loss, gallbladder perforation rate, postoperative pain, and complications.

    Results:  HS provides a shorter operative duration than CC (34.85±6.2 min vs. 49.75±9.49 min, respectively, p=0.0001), with a significant less incidence of gallbladder perforation (6.6% vs. 20%; p= 0.032). There was no statistical difference in the conversion rate between both groups. The amount of postoperative drainage is significantly less in HS (37.98±17.25 vs. 49.18±22.65 ml; p = 0.003). No postoperative bile leak was encountered in HS, but it occurred in 3.3% of patients in CC. Visual analog scale (VAS) for pain severity in HS at 24 hours postoperative was (3.95±0.74 vs. 4.94±1.34, p=0.0001).

    Conclusion: HS provides a complete hemobiliary stasis and is a safe alternative to standard clipping of cystic duct and artery. It provides a shorter operative duration, less incidence of gallbladder perforation, less operative blood loss, less postoperative pain, and less rate of conversion to open cholecystectomy.

    Keywords:Laparoscopic cholecystectomy (LC), Clips and Cautery (CC), Harmonic scalpel (HS).

     

    P.P.:109-115

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  • Article title : Synthetic vertebral body implantationFunctional outcome in management of spinal disorders
    Description :
    زرع الفقرة الصناعية

    Moneer K. Faraj*      FICMS, FACS, FICS, IFAANS

    Abstract:

    Background: Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections and even tumor conditions

    Objective: To assess the functional outcome of this modality in different spinal conditions.

    Patients and Methods: twenty-seven cases operated from Oct. 2010 to Dec. 9 cases had spinal fractures, 8 cases with spinal tuberculosis, and 10 cases with spinal tumors. They were followed clinically for a mean period of 36 months.

    Results: All the cases approached anteriorly. 5 cases had postoperative infection. No neurological worsening reported. we had dramatic neurological improvement in all spinal tuberculosis cases. Mortality reported in only three case with metastatic spinal tumor during the mean period of follow up.

    Conclusion: the outcome of this surgery making it recommended for properly selected patients especially with spinal tuberculosis and tumors.

    Keywords: synthetic vertebral body, implantation, spinal fractures, spinal tuberculosis, spinal tumors

    P.P.:116-120

     

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  • Article title : Review of 31 cases of neonatal gastrointestinal perforations
    Description :
    الامعاء في الاطفال حديثي الولادة فيما يخص المميزات الديموغرافية والتشخيص السريري

     

    Haithem H. Ali Almoamin*         FIBMS

     

    Abstract:

    Background:Despite the recently improved neonatal intensive management, gastrointestinal perforation during the neonatal period is still a major challenge for pediatric surgeons.

    Objective: To reviewthe effects of different clinical and operative parameters on the mortality of neonatal intestinal perforations.

    Patients and Methods: A retrospective study was done to 31 cases of neonatal intestinal perforation at the neonatal intensive care unit of Basrah children speciality hospital during the past four and half years (July 2011 to December 2015). Information regarding the age, sex, gestational age, birth weight, clinical examination, x-rays value in diagnosis, causes and sites of perforations, types of operative procedures, and their effects on prognosis are all studied.

    Results:Maleswere affected more than females (a ratio of 3.4: 1); birth weight has a significant association with the prognosis (P-value of 0.045). Hirschsprung`s disease was the commonest cause for perforation (29%), followed by necrotizing enterocolitis and jejunoileal atresia (16.1%, each).Idiopathic perforations constituted only 12.9%. Ileum was the commonest site of perforation (58.1%), followed by cecum (16.1%). Stoma creation was the commonest operative procedure performed. Other procedures like, primary anastomosis, and primary peritoneal drainage followed by laparotomy were also used. This study revealed high mortality rate (45.2%). Complications like sepsis, anastomotic leaks, or burst abdomen carried a high risk of death.

    Conclusions:High mortality rate is encountered, especially for necrotizing enterocolitis. In contrast to other study, Hirschsprung`s disease is the commonest cause of perforation rather than necrotizing enterocolitis. Radiology has a relatively good accuracy in the diagnosis of intestinal perforations, although some cases were discovered intra-operatively. In this series, prompt accurate treatment with stoma creation harbored the best prognostic results; furthermore no benefits obtained from primary peritoneal drainage.

    Keywords:neonates, perforations, intestine, mortality.

    P.P.:121-125

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  • Article title : Indications and complications of peritoneal dialysis inchildren with acute renal failure, a single center experience
    Description :
    موجبات ومضاعفات غسيل الكلى البريتوني في الأطفال الذين يعانون من فشل كلوي حاد، ,تجربة مركز واحد

    Nariman F.A.Azat*    CABP,FICMS-ped,nephrology

    Abstract:

    Background: Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute renal failure (ARF) in children and hemodynamically unstable patients, because of its inherent advantages: technique can be initiated simply and quickly, no highly trained personnel nor expensive and complex apparatus are requiredand  systemic anticoagulation is not needed.

    Objectives: is to highlight the role of peritoneal dialysis in management of children with acute renal failureand to determined its complications.

    Patients and methods: A retrospective study was carried out from 20thApril 2012 till1stMay 2014 ,on  children with acute renal failure admitted to nephrology unit in Child Welfare Teaching Hospital and peritoneal dialysis was done for them in the  acute intermittent peritoneal dialysis  ward which was established since 2012 . Age ranged from one day up to fifteen years .Indications, complications of the procedure and outcome of recovery were recorded.

    Results:Fifty ninechildren with acute renal failure were enrolled in the present study 23(39%) female and 36(61%) male, their age ranged from (8 days-15 years ). congenital  malformations of renal system 13 (22%),  hemolytic uremic syndrome 10(16.9%), sepsis 7(11.9%) were the predominant causes of acute renal failure. Complications of dialysis were significantly low among studied patients 18.6%(p<0.001).The main dialysis related complication was catheter malfunction(45%). The incidence of peritonitis 1(9%)(P=0.01).Recovery of renal function after peritoneal dialysis found in 42 patients Survival rate among these patients was 97.6%  (p<0.001) .Overall mortality was 22%. The most common cause of death was septicemia in (57%) of patients.

    Conclusions: Because of its simplicity and feasibility, acute PD is still an appropriate treatment choice for children with ARF

    Key words:acute renal failure,children, peritoneal dialysis

    P.P.:126-131

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  • Article title : Hemostatic parameters in Thalassemia patients; a single institute experience
    Description :
    معايير التخثر في مرضى فقر دم البحر المتوسط: خبرة مركز واحد

    Safa A. Faraj*         FICMS (Ped.), FICMS (Hem.), DCH

    Abstract:

    Background: Changes of coagulation profile have been described in patients with B-Thalassemia major. Prolongation of prothrombin time and partial thromboplastin time and reduced levels of coagulation factors and natural anticoagulants have been variously described though the mechanisms involved in the thrombotic tendency seen in some Thalassemia patients have not been fully clarified.

    Objectives: To investigate changes in the coagulation profile in patients with B-Thalassemia according to the available hemostatic parameters in Thalassemia patients in Al-Karama Teaching Hospital in Wasit governorate.

    Methods:Hemostatic variables were studied in pre-transfusion blood samples from 50 transfusion-dependent children with Beta Thalassemia (mean age 13.2 years) and from 20 healthy controls. 

    Results: Laboratory evaluation showed thrombocytopenia in 43.5%, prolongation of prothrombin time (PT) in 54% and prolongation of activated partial thromboplastin time (aPTT) in 56% of the patients. All measured coagulation factors level were low in activity as compared with control group. Serum ferritin had positive correlation with PTT and PT (r=0.12 and r=0.11 respectively) and significant negative correlation with platelet count (r=-0.3).

    Conclusions: Changes in the hemostasis in Thalassemia patients is notifiable.These laboratory finding may be subclinical, but play important role in anticipation of future hemorrhagic manifestation and thrombotic events.

    Keywords: Bleeding, Thalassemia, hemostasis

    P.P.:132-135

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  • Article title : Serum Prostate Specific Antigen level in Women with Polycystic Ovary Syndrome
    Description :
    مستوى مستضد البروستات المحدد (PSA) في مصل الدم لدى النساء ذوي مرض متعددة تكيس المبايض

    Wasan W. Ibrahim*       MBChB, CABOG, FICOG

    Raya Kh. Salah**          MBChB, FICOG

    Widad M. Abbas**      MBChB

     

    Abstract:

    Background:Polycystic ovary syndrome (PCOS) is a common disorder in women in the reproductive age associated with disturbance of reproductive, endocrine and metabolic functions. The pathophysiology of PCOS appears to be multifactorial and polygenic.

    Objective:To measure the level of prostate –specific antigen (PSA) and to evaluate the value of prostatic specific antigen as a marker of hyperandrogenism in women with PCOS.

    Patients and Methods: One hundred women were entrolled in this study, 50 women were PCOS group and the remainder was healthy women served as control group.Hormonal profile (serum testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) levels were measured. Ferriman-Gallway Score (FGS) was assessed. Serum prostate specific antigen level was measured in both groups. Correlation between PSA level and (LH/FSH, testosterone and FGS) were evaluated.

    Result: Mean serum PSA level was significantly higher in PCOS women compared to control women (0.15  0.09, 0.016 0.003) respectively with P value <0.05 ).Serum PSA level in women with PCOS had significant positive correlation with FGS, LH/FSH ratio and serum testosterone with r values: 0.964, 0.988, 0.922 respectively.There was a strong correlation between serum PSA levels with the degree of hirsutism as evaluated by Ferriman –Gallwayscore .Serum PSA level in the 1st group ( 4-8 ) was 0.07 0.009, in the 2 nd group ( FGS9-12 ) was 0.1  0.06 and in the 3 rd group ( FGS 13-16 ) was 0.3  0.03 .

    Conclusion: Prostate – specific antigen level is significantly higher in women with PCOS and correlate positively with LH/FSH, testosterone and Ferriman-Gallway score. It is also concluded that the higher score of hirsutismcorrelate with the higher serum PSA level.

    Key words:Polycystic ovary syndrome, Prostate specific antigen ,Ferriman –Gallway score .

    P.P.:136-139

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  • Article title : Imaging and clinicopathologicalcharacteristicsof breast cancer among women under the age of40 years
    Description :
    السمات السريرية والتصويرية والمرضية لسرطان الثدي لدى النساء دون سن الاربعين

    Abdullateef A. Mustafa* MBChB, CABMS-RAD

    Nada A.S.Hasan* MBChB, MSc, PhD

    Enam A.Khalel**MBChB, DMRD

    Abstract

    Background: although breast cancer in young women is less common and often overlooked, it is still considered a major health concern.

    Objectives: to evaluate the demographic, clinical, radiological and histopathological characteristics of breast cancer among a sample of Iraqi women diagnosed under the age of 40 years.

    Patients and methods: aretrospective study enrolled73 females below the age of 40 years with a history of breast cancer. All data was extracted from an established information system database designed by the Principal Investigator of the Iraqi National Breast Cancer Research Project under supervision of the International Agency for Research on Cancer (IARC) over a 4-years period from 2011 to 2014.

    Results:seventy three women under the age of 40 years with breast cancer were included in the study out of 625 diagnosed cases at different ages (11.68%). The age at presentation ranged from 25 to 39 years, the peak age frequency (63%) was recorded in the period between 35-39 years (n=46). Family history of breast cancer was noticed in approximately 31.5% of cases (n=23). Early menarche (less than 12 years old) was detected in 78.1% (n=57) of cases.On examination, 90.4% (n=66) of patients had painless palpable breast lump. By Sonography, the lesions werespiculated margins in 52% (n=38) of patients and echogenic halo around the mass was detected in 57.5% (n=42) of cases. Stage-II disease was recognized in 54.8% (n=40) of sample of the study and majority of the tumor (98.6%) were ductal in origin. According to Scarf-Bloom-Richardson method, 60.3% (n=44) of the tumors were moderately differentiated (i.e. grade- II). Eight patients (10.9%) were presented with triple receptor-negative breast cancer and recurrence of tumor was encountered in 17.8% (n=13) of cases.

    Conclusions:The current study suggest that breast cancer among young Iraqi womenunder 40 years had high incidence rate but might be less aggressive than what is reported in western countries despite of high recurrence rate.   

    Key words: breast, cancer, young age, Iraq.

    P.P.:140-145

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  • Article title : Effect of post-traumatic stress disorder on school achievement among secondary school students in Baghdad, Iraq
    Description :
    تاثير الكرب التالي للرضح على التحصيل الدراسي لطلبة المدارس الثانوية في بغداد – العراق

    Nesif J. Al-Hemiary*       MB ChB, FIBMS

    Mushtaq T. Hashim *        MB ChB, CABPsych

    Ameel F. Al-Shawi**        MB ChB, MSc, PhD

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

     

    Abstract:

    Background: Iraqipeople were exposed to mass disasters for long periods of time. Posttraumatic stress disorder(PTSD) may be of particular interest following a mass disaster. Evidence of poor school outcomes among adolescents affected by violence has been reported.

    Objectives: To study the effect of PTSD on school achievement among secondary school children in Baghdad, Iraq.

    Materials and methods:A total of 240 secondary school students from 4 secondary schools (2 for boys and 2 for girls) from Baghdad city were included. Multistage random sampling was carried out. Each student was interviewed and a questionnaire (consisted of demographic information, Harvard Trauma Questionnaire, and academic failure) was filled. Academic failure was indicated by poor school achievement.

    Results: Students with PTSD were 37.1%. No significant association was found between age, sex and PTSD.Of those with PTSD, 86.5% had bad school achievement.

    Conclusion:high rate of PTSD was reported among secondary school students, and PTSD had a negative impact on their school achievement.

    Key words: PTSD, school achievement, Iraq, widespread violence

    P.P.:146-148

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  • Article title : The Relationship between Severity of Dental Caries and Chronic Tonsillitis among Iraqi Children  
    Description :
    العلاقة بين شدة تسوس الأسنان والتهاب اللوزتين المزمن بين الأطفال
    Zaid S.  H. Ahmed *   BDS, MSc, PhD,

    Abstract:

    Background: Chronic Tonsillitis outcomes from frequent attacks of acute Tonsillitis usually for six attacks or more per year for two successive years. Poor dental hygiene had been associated with oro- pharyngeal problems and causes both dental caries and Tonsillitis alike.

    Objective: To evaluate the relation between chronic Tonsillitis and severity of dental caries among 4-5 years old children.

    Patients and Methods: Random sample of children was selected in Hospital of Baghdad medical city Otolaryngologic department city. Fifty-four children aged 4- 5 years old were participated in this study divided into two group: 29 children with Chronic Tonsillitis (study group) and 25 children with intact tonsils (control group). The determination of Chronic Tonsillitis performed through a clinical and histopathological examination and Caries experience was recorded according to Mühlemann (d1-4 mfs) Index.  

    Results: Bacteriologic samples from children dental plaque(29 infected and 25 healthy) were cultured quantitatively for aerobic condition; Data reported that the mean values of bacteria (Strep. mutans, Strep. pyogenes, Lactobacilus spp, Strep. mitis and Strept. salivarius) and  dental caries  (dmfs, decayed, missing d3 and d4) among  children with  Chronic Tonsillitis were higher  than children with intact tonsils with statistically highly significant difference (P< 0.001). Moreover the relations between (d4)  and Strep. mutans, Lactobacilus spp and Strep. mitis were highly significant in positive direction among  study group (children  with Chronic Tonsillitis), while it was not among control group (children with intact tonsils).

    Conclusion There seems to be an association between dental caries and Chronic Tonsillitis in children aged 4-5 years old. And, it may be accepted that the infection to pass much more frequently from the teeth to the tonsils than in the opposite direction. So It is necessary to improve oral health condition through elective preventive dental programs among children to minimize any para-pharyngeal infections like Tonsillitis.

    Keywords: Dental Caries, Children, Tonsillitis, Oral Microflora, Dental Plaque

    P.P.:149-153

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  • Article title : Effectiveness of Health Educational Program upon Nurses' practices toward Care of Newborns with Neonatal Jaundice  
    Description :
    تأثير برنامج تثقيفي صحي على ممارسات الممرضين تجاه العناية بالأطفال حديثي الولادة المصابين باليرقان الولادي

    Suad H. Khudhair*       PhD

    Abstract:

    Background: Effectiveness of health educational program upon nurses' practices toward care of newborn with neonatal jaundice in neonatal intensive care unit in pediatric teaching hospitals at Baghdad city.

    Objective: The study aims to apply ahealth educational programto improvenurse practical skills toward neonatal jaundice and find the relationship between the nurses' practices and their demographic characteristics.

    Patients and Method: A Quasi experimental studywas carried out in 3 teaching hospitals (Welfare pediatric Teaching Hospital, Central Pediatric Teaching Hospital and Al-Kadhimiyia Teaching Hospital)in Baghdad City from the 12th June 2015 to 28th ofDecember 2015. The sample (30) nurses who are working in the neonatal intensive care unit. The data were collected through using constructed questionnaire which comprises (50) items. The questionnaire used in pre test before conduction of the program and post test 1 immediately after the application of the program, post test and repeated  posttest 2 after two months from first post-test 1. The reliability of the questionnaire was determined through a pilot study and validity through a panel of experts. The data were analyzed through the application of descriptive statistic frequency, percentage, and the application of inferential statistical procedures, which include Pearson correlation coefficient and chi-square.

    Results: The findings of the study indicated that nurses have poor practices in pretest. But post evaluation revealed good level of practices among nurses toward neonatal jaundice in the neonatal intensive care unit.  The program reflects effects on nurse's practices. There were no statistical significant association between nurses' practices and their demographic characteristicsConclusion:There was no statistical significant association between nurses' practice and their demographic characteristics. The study demonstrated that there was poor nurses' practice at NICU toward care of newborn with neonatal jaundice before application program in pretest and good practices in post 1 and posttest 2.

    Keywords:Health educational program, Nurses' Practices, Neonatal Jaundice.

    P.P.:154-158

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  • Article title : Classification of anemia in hemodialysis patients in relation to vascular access and its correlation with hepcidin and ferritin
    Description :
    تصنيف فقر الدم في مرضى ديلزة الدم وحسب طريقة المدخل الوعائي وعلاقته بالهبسدين والفرتين

    Haithem A. Al-Rubaie*      FICMS-Pathology (Hematology)

    Dhalal D. Hasan**                    MSc

    Raid A. Al-Rubay***               CABM, MD

                                         

    Abstract:

    Background: Anemia is very common in patients with chronic kidney disease, and becoming almost universal in end stage renal disease, where dialysis or renal transplantation becoming the treatment of choice. High levels of hepcidin appear to accompany reduced renal function and serum ferritin may also be elevated.

    Objectives: To classify anemia in hemodialysis patients and to display the correlations between the types of anemia and inflammatory parameters like hepcidin and ferritin according to vascular access of hemodialysis.

    Patients and methods:This case-control study was conducted at Al-Hayat center for hemodialysis, and included 60 adult patients on hemodialysis. Also 20 healthy individuals were recruited as control group. Measurement of hemoglobin, erythrocyte sedimentation rate, transferrin saturation percentage, serum ferritin, C-reactive protein and hepcidin were done. Anemic patients were classified into; anemia of chronic disorder, iron deficiency anemia, combined, and others. Patients were also divided into two groups depending on their vascular access of hemodialysis.

    Results: Anemia of chronic diseases was the most frequent anemia (45%) among the patients followed by combined anemia of chronic diseases/iron deficiency anemia then iron deficiency and other causes. No significant difference was observed between types of anemia and inflammatory parameters according to patients’ vascular access of hemodialysis. There was no significant difference in the mean levels of hepcidin, ferritin, ESR and CRP of the patients according to the vascular access of hemodialysis, while hemoglobin level of patients with ACD in double lumen was significantly lower than those with arteriovenous fistula, P= 0.007.

    Conclusions: Anemia of chronic diseases was the most frequent in HD patients. There are higher levels of inflammatory parameters in HD patients than healthy controls.

    Key words: Hemodialysis, anemia, hepcidin, ferritin, CRP.

    P.P.:159-164

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  • Article title : Immunohitochemical expression of Bcl-2in human colocrectal carcinoma
    Description :
     

     في سرطان القولون والمستقيم (bcl-2 )التعبير المناعي النسيجي للمعلم السرطاني ال

       KifahH.AbdulGhafour*               MBChB,PhD (Path.)                                                      Tharwa H. Hassan AL-Tai**       BSc,MSc Microbiology

      Hind  H.  shaker **                         BSc,MSc Microbiology

    Abstract

    Background:Colorectal carcinoma is the most frequent type of malignancy in terms of incidence,it is the third most common cancer worldwide in both sexes . bcl_2 expression has been described as been a better prognostic factor in colorectal carcinoma .

    Objcetives:-To determine the frequency and the pattern of Bcl-2 expression in colorectal carcinoma by immunohistochemical technique and to correlate this expression with different clinicopathological parameters.

    Material and method:-Thirty cases of colorectal carcinoma were studied, these cases were diagnosed in private laboratories in Baghdad / Iraq from January 2015 to Juan 2015. Clinicopathological parameter such as age, gender , pathological diagnosis , tumor site , lymph nodes status , grade and stage of tumor were collected from patients files..Sections of 4µm were stained by hematoxylen and eosin stain, and immunohistochemical stained for Bcl-2.

    Results:-Nineteen (63.3%) 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. Histologically the tumor grade range from moderately differentiated in 27 (90%) cases and poorly differentiated in 3 (10%) cases. Ten (33.3%)cases locatedin the right colon and sigmoid each 6(20%) cases in rectum,8(26.7%) cases in the cecum,3(10%)cases located in right colon and sigmoid each,6(20%) cases in the rectum and 8(26.7%) cases in the left colon. Regarding pathological staging (TNM system),2 (6.7%) cases were stage T2 ,24 (80%) were stage T3 ,4(13.3%) cases wereT4. Lymph node involvement found in 14(46%) cases and distantmetastasis was found in9(30%) cases. Bcl-2 expression was present in 14(46.7 %) cases of 30 colorectal carcinoma.There was no significant correlation with age, sex, histopathological grade, location, lymph nodes status and tumor invation.

    Conclusion:-There was no significant statistical correlation betweenbcl expression by tumor cell of colorectal carcinoma and different clinicopathological parameters in this study.

    Keywords: Colorectal cancer,Bcl-2 expression

    P.P.:165-169

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  • Article title : Detection of Hepatitis -B virus Genotypes among Chronic Carriers in Duhok
    Description :
    تحديد الانواع الجينية لفيروس التهاب الكبد –ب- في الحاملين المزمنين في دهوك/العراق

    Ibrahim M.  Abdulla*             MSc. Microbiology

    Amer Abdalla Goreal **        FIBMS

    Abstract:

    Background: Hepatitis B virus (HBV) is one of the major etiological agents causing acute and chronic liver disease worldwide with significant morbidity and mortality. The high genetic variability of HBV is reflected by eight genotypes (A to H), each with a particular geographical prevalence.

    Objectives: The study was conducted to find out HBV genotypes in chronic hepatitis B- (CHB) carriers in association with serological markers of HBV.

    Methods: This work was carried on from March to, December 2012 in Duhok/Iraq and enrolled 134 HBsAg positive carrier cases. recruited to Central Public Health Lab. Specific primers PCR technique was used to detect HBV genotypes. The carrier cases were screened for markers of HBV infection by Enzyme Linked Immunosorbent Assay (ELISA). Automated machine for quantitative determination of ALT was used.

    Results: The carrier cases were 91 males (67.9 %), 43 females (32.1 %), and their age range was 10-87 year old (mean=31.4 SD± 13.3). Among the studied patients 133(99.2%) were found to have genotypes D including 91(67.9%) males and 42(31.3%) females and only one female patient carried genotype B (0.8%). Anti-HBc(total), IgM anti-HBc, HBeAg and  Anti HBeAb were detected in rates of 100%,0%,50%and 46.9 % respectively. The patient with genotype B had positive HBe Ag, negative HBeAb and normal ALT level.

    Conclusion: This study revealed that hepatitis B virus genotype D is the main genotype in Duhok/ Iraq followed by genotype B. High percentage of CHB patients with genotype D are HBeAg positive. Most of CHB patients with high ALT level had positive HBeAg rather than negative HBeAg.

    Key words: HBV genotype; HBeAg; Nested PCR; ALT; ELISA;

    P.P.:170-175

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  • Article title : HLA Diversity in Iraqi Population: Molecular Typing
    Description :

    تنوع مستضدات الخلايا البيض البشرية في المجتمع العراقي: تنميط جزيئي

    Ahmed A.H. Abbas*     MSc, PhD

    Abstract

    Background:  Human leukocyte antigen (HLA) is the most polymorphic system in human. The distribution of HLA- alleles varies in different populations.

    Objective: This study was conducted to highlight on alleles frequency of HLA in Iraqi population by using molecular technique.

     Patients and methods: Two hundred individuals were genotyped for HLA class I and II alleles by polymerase chain reaction sequence-specific oligonucleotides (PCR-SSO).

    Results: The present study observed that the alleles with highest frequency for HLA-A,B,C,DR and DQ region were: [A*02(27.75%), A*01(10.75%), B*51(17.75%), B*35(9%),   C*04(26.75%), C*07(20.25%), DRB1*02(17.5%), DRB1*07(17%), DQB1*01(25.5%) and DQB1*03(21.75%)].

    Conclusion: The frequency of HLA alleles in Iraqi Arabs partly different when compared with some populations around the world, however; this data is useful in field of response to vaccines and therapy, anthropology and could be provide standard control for future Iraqi studies about the HLA association with different diseases.

     Key words: HLA; Iraq; PCR

    P.P.:176-179

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  • Article title : Evaluation of inhibin-B hormone,FSH, and Testosterone in serum of infertile men
    Description :

     

    تقييم هرمون ال انهبين ب وهرمون المنبه للجريب وهرمون التستيستيرون في الذكور المصابين بالعقم

    Shatha Al-Khateeb*                BSc,  PhD

    Sabah M. Hussein**         MBChB, PhD

    Ahmad A. A. IbrahemDahy*.BM (Tech), MSc

    Abstract:

    Background: Serum levels of inhibinBhormone , FH and testosterone hormone in serum of infertile men and compare the results with the fertile men (cotrols).Thirty patients (infertile men) healthy 14 controls included in this study.mean serum inhibinB ,testosterone and FH level of oligospermia and azoospermia groups were significantly differences than these both control group.

    Objective:The study was planned to evaluate serum levels of inhibinBhormone , FSH and testosterone hormone in infertile men and compare the results  with these fertile men (Controls).

    Materials&Methods: Thirty patients (infertile men) and 14 healthy controls (fertile men) included in this study, Age range (24 to 45 years).The patients (30)were divided into two groups, oligoospermia and azoospermia.

    Results:Mean serum inhibinB,testosterone and FSH levels of oligospermia and azoospermia groups were significantly differences than these both  control group, whilethe difference between mean of serum inhibin B ,testosterone and FSH of oligospermia and oligospermia group , was not significant except the FSH (P.value=0.039).

    Conclusion:The decrease in serum inhibinB and testosterone levels not the  increasein the level of FSH hormone in infertile men  provide evidence that  levels can be used as reliable markers in the diagnostic criteria of male infertility .

    Keywords:oligoospermia,  azoospermia  ,inhibinB , serum .

    P.P.:180-182

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  • Article title : Study the preventiveeffectof aqueous extract of Gingko bilobaoncerebral damage induced by ischemia/reperfusion in rat
    Description :
    دراسة التأثير الوقائي للمستخلص المائي للجنكه بيلوبا على الضرر الدماغي الناجم عن نقص التروية واعادة التنشيط لدى الجرذان

     Mustafa T. Mohammed*BSc, MSc, PhD (Biochemistry)

    Abstract:

    Background: Background: cerebral damage may occur in a variety of clinical settings and this remains a significant problem.  Therefore, it seems possible that the administration aqueous extract of Gingko biloba  might protect the brain  against the ischemia reperfusion injury.

    Objectives:The study included knowledge Phytochemical Composition and determine whetherGingko bilobain the aqueous extract prevents or decreasesI/R brain damage.

    Methods:Thirty rats were divided into three groups as control, I/R group andGingko biloba treatment group. Serum was used for the estimation of biochemical parameters: oxidative stress levels of nitric oxide (NO) and lipid peroxida­tion (LPO) and blood was used for the estimation of enzyme immunoassay:Interleukin-8 (IL-8), tumor necrosis factor Alpha (TNF-α), interleukin-1β (IL-1β).

    Results:The results showed that the extract contain : glycosides , saponins ,tannins ,phenolic compounds , resins, flavonoids ,alkaloids and proteins.The levels of Oxidative stress in group 3 were significantly lower than those in group 2 as well as the levels of enzyme immunoassay in group 3 were significantly lower than those in group 2.

    Conclusion:The present results suggest thatGingko bilobatreatment protects the rat brain against ischemia-reperfusionbrain damage.

    Key words:Gingko biloba, preventive effect, ischemia/reperfusion , brain damage.

    P.P.:183-186

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  • Article title : Determination of benzo (a) pyrene in Iraqi Chicken, doner kebab and fish samples cooked with charcoal or gas fire
    Description :
    قياس تركيز بنزو(اي) بايرين( مركب مسرطن في نماذج من الدجاج والكباب والسمك العراقي المشوي بالفحم تارة والغاز تارة اخرى


    Khalid N. Jasim* PhD
    Samir L. Shkhaier** MSc

    Abstract:

    Background: Polycyclic aromatic hydrocarbons (PAHs) have been found in protein-rich food products where they are generated during certain food processing procedures. Benzo[a]pyrene (B(a)P) is a member of a class of PAHs in which the molecular structure includes two or more fused aromatic rings with adjacent rings sharing two or more carbon atoms with the formula C20H12. Dietary intake of these compounds via a formation of B(a)P on processing or cooking lead to metastasis of tumors at several sites, particularly in the upper gastrointestinal tract.
    Objective: We aimed to determinate B(a)P in charcoal and gas broiled chicken, doner kebab and fish meats taken from some restaurants in Baghdad.
    Methods: Prospective study was done in Baghdad from july to decemper 2015 in (Palestine st and alsadria). 120 samples of chicken, doner kebab and fish were collected from some resturants in Baghdad area randomly.A 20 cooked samples using a charcoal fire and gas fire for each kind of meat mentioned above to determinate B(a)P in these samples.HPLC technique was used for determination.
    Results: Mean levels of B(a)P were found to be (11.6±11.08 μg/kg) ,(10.0±9.4 μg/kg) and (8.4±7.8 μg/kg) for a charcoal fire broiled chicken, doner kebab and fish respectively while mean levels of B(a)P were found to be (2.5±1.9 μg/kg) ,(2.3±1.7 μg/kg) and (2.0±1.4 μg/kg) for a gas fire respectively.
    Conclusion: The B(a)P levels of three samples cooked on a charcoal fire exceeded the maximum tolerance level for B(a)P of the European Union establishment (2005). The highest levels of B(a)P were found in charcoal-grilled samples.Therefore,present study provides important information on B(a)P in charcoal grilled meats in Iraq. This might help to avoid the contamination in food processing to secure food safety and to protect iraqi citizens.
    Keywords: Benzo (a) pyrene, meat ,chicken,doner kebab ,fish.

    P.P.:187-191

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  • Article title : The associationbetween hormonal variation, antioxidant statusand oxidative stress in Iraqi womenwith endometriosis
    Description :
    العلاقة بين الاختلاف الهرموني, حالات مضادات الاكسدة و الشد التأكسدي في النساء العراقيات المصابات بهجرة

     Tamara  S. Naji*                           MSc

    SalwaH.N. Al- Rubae'I*    PhD 

    KismaM. Turki**                       PhD 

     

    Abstract:

    Background: In  the  last  years,  Endometriosis  affects  up  to  10  percent  of  reproductive  aged  Iraqi  women.  Little  is  known  about  the  etiology  of  endometriosis  in  Iraqi  women.

    Objectives:  The  aimof  this  study is  to  investigate  the  hormonal  changes,  antioxidant  status,  Coenzyme Q10and  oxidative  stressin  women  patients  with  endometriosis.

    Patients  and  methods:30endometriotic women  mean  aged  (31.16±5.61 year )  who  were  undergoing  laparoscopyto  participate  in  this  study,  and  (n=30)  healthy  women  volunteers  mean  aged  (31.96±5.42year)  as  control  group.

    Results: The  results  in  this  study  revealed  a  highly  significant  increased  (P<0.01)  in  estradiol  (E2),  uric acid  (UA)  and  oxidative stress  (MDA).  The  results  of  the  Coenzyme Q10  (CoQ10) andvitamins  (A,  E,  β-carotene,  C)showed  a  highly  significant  decreased  (P<0.01)  in  the  sera  levels  of  patients  with  endometriosisas  compared  to  control.  This  study  showed,  there  was  a  significant  negative  correlation  between  the  levels  ofLuteinizing  Hormone  (LH),  Follicle  Stimulating  Hormones  (FSH),  Testosterone  (Test.),  E2  and  vitamins,  whereas  a  significant  positive  correlation  was  observed  in  UA level with   concomitant   increase   in   MDA  levels.

    Conclusions: The  results  of  this  study  concluded  the  increase  of  oxidative  stress  and  the decrease of  antioxidant  vitamins  and  CoQ10. Thus  increasing  the  growth  and  adhesion  of  endometrial  cells  in  the  peritoneal  cavity,  which  willlead  to  increase  the  risk  factorsofendometriosis.

    Keywords:Endometriosis, antioxidants status,  oxidative  stress,  hormone  changes  and  CoQ10

    P.P.:192-196

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