The Medical Journal of Tikrit University

Background Iron overload is a major problem to thalassemia major patients. For the treatment of those patients, there is an important role played by the effective and safe iron chelating protocol with high compliance rate. This prospective comparative study was conducted for the assessment of the deference in the response of serum ferritin and safety of combined Deferasirox (DFX) - Deferoxamine (DFO) therapy and deferasirox (DFX) protocol in a group of transfusion-dependent thalassemia major patients in Najaf thalassemia center, Iraq.
Material and Method Forty two patients were studied, aged between 2 to 30 years old, mean SD (8±3). Patients divided in to two groups, 29 patients chosen randomly on DFX (40 mg/kg/day), and 13 patients were willing to continue combined therapy of DFO(20mg/kg/day infusion ,two days /week) and DFX.The duration of study was one year. Efficacy of both regimes determined by assessment of serum ferritin level before and after treatment in both group, and the safety assessed by frequent monitoring of liver enzymes , blood urea and serum creatinine.
Results After one year of therapy, patients on DFX alone have shown significant reduction of serum ferritin from mean (4482±452) range (1148-10450 ng/l), to mean of serum ferritin (3132±336) range (595-8743 ng/l) No significant changes were observed in this study regarding blood urea and liver enzymes, but fortunately there was a decline in (ALT), from mean value of (82±16), to mean value (56±6).

Background Human Cytomegalovirus (CMV) is the most common cause of congenital malformation resulting from viral intrauterine infection in developed countries. Congenital HCMV infection causes severe morbidity and mortality in newborns and is the infectious cause of deafness, vision loss, and mental retardation and neurodevelopmental abnormalities in children.The aim of this study was to estimate of some immunological parameters in aborted women infected with Human Cytomegalovirus (HCMV) in Salah Al-deen province. Pateints & Methods:This study was carried out on 128 pregnant women with abortion at 15-45 years who attended Tikrit teaching hospital in Salah Al-deen province. Five ml of blood were drawn from each pregnant woman for separation of the sera. The ELISA test was used for estimating the levels of CMV-IgM and CMV-IgG antibodies in patient's serum.
The Results The present study revealed that 21 out of 128 (16.40%) aborted women had antibodies against CMV (either IgM or IgG), while 83.59% of women were without known cause of abortion. The aborted pregnant women with CMV infection was 21 (16.40%) out of 128 pregnant women with abortion, while, it was 107(83.59%) aborted women had other causes of abortion, meantime the major of pregnant women with abortion were positive for CMV-IgG which reached 71.42%, whereas the percentage of CMV-IgM positive was 28.57 %. The most infected age groups with CMV infection was 25 – 34 years old, which represented 12 (57.14%), case. The most infected patients from rural area was 71.42%, while in urban was 28.57%. The most pregnant women with CMV infection were had previous abortions within first trimester (less than 12 weeks of gestational age) was 55.5% case. The conclusion of this study was the seropositive of pregnant women with CMV high at 25-34 years age from rural area especially at first trimester.

Background Polycystic Ovary Syndrome - PCOS- is the most common endocrine disease that affects women of reproductive age. The Aim is to assess the levels of thyroid antibodies in women with PCOS in Iraq, and to learning the link between PCOS and thyroid hormones.
Patients & Methods: Two study groups have been investigated; the first group consists of one hundred and five infertile women with PCOS. The second group is healthy control which consists of forty six healthy fertile women. Hormonal analysis was performed by using a ready kit in accordance with the manufacturer's instruction (Biomerieux SA Etoile-France) and minividas full automated system (Triiodothyronine) .Thyroxine is performed by a one-step enzyme immunoassay competition method with a final fluorescent detection (ELIFA) (Enzymelinked immunoflourecent assay) and minividas full automated system (Biomerieux SA Etoile- France). Thyroid stimulation hormones , anti -thyroid peroxidase autoantibodies ,anti-TPO and anti -thyroglobulin antibodies Tg is performed by means of immunoassay sandwich with a final fluorescent detection (ELIFA) method with the use of a ready kit in accordance to the manufacturer's instruction (Biomerieux) and MiniVidas Full automated system (Biomerieux).
The Results: It was found a highly significant difference (p< 0.01) between the thyroid stimulation hormone means (7.03± 13.45) µIU/ml of the infertile women with a mean of (3.51±4.43) µIU/ml of the control group, while the mean of Triiodothyronine and Thyroxine was found a slightly significant difference (0.05>p>0.1),). A positive result was found for thyroid peroxidase antibody (TPO- Abs)in infertile women (19.95 1± 39.53) IU/ml was higher than that of the control (4.82±4.7 ) IU/ml; anti-Tg autoantibodies in infertile women were (31.31±65.86) IU/ml compared to control (11.75±27.30) IU/ml with a significant difference(P=0.001).

Background Internally displaced persons (IDPs) are persons who are forced to free or leave their homes or places, and they are more vulnerable groups specially the children , women and elderly. Tuberculosis is one of the public health problems facing Internally displaced persons.
Aim: This study was conducted to show the prevalence and outcome of tuberculosis among IDPs.
Patients and Methods: A total of 173 IDPs were followed up for the period of DOTS program treatment and their outcome was detected according to the DOTS strategy, The activity of the context of increased T.B detection and control among IDPS has been concluded in NTP program during 2011. There was delay in obtaining two mobile clinic to visit IDPS , was postponed to 2013 ,it was started during 2013 by the disturbing educational maternal (1000) copy brochures. A sampling of all T.B patients, whether they are smear positive, smear negative , or extrapulmonary as well as multidrug resistance were included. The local T.B program network in Kirkuk governorate is comprised of one T.B consulatory clinic and 10 diagnostic lab. distributed around the 6 districts
Results: Out of 400000 IDPs , 173 were registered as T.B ,120 were completed 6 months treatment with 74% success rate, while (53)40% were lost to follow up . Conclusion: It was concluded that IDPs needs more active follow up to complete their long duration treatment.

Background Malnutrition is one of the most common serious diseases in the world, in which it carry high morbidity and mortality rates. and most of those children commonly exposed to anemic, for many reasons like low iron, folic acid,vit B12 in the food, also impaired absorption due to presence of chronic illnesses or parasitic infestations. Anemia most commonly measured as grams of hemoglobin per liter of blood.
Cutoffs to define anemia are 11 gram per dl for children 6-59 months . Aim: To find the types of anemia using blood film examination in malnourished children
Patients and Methods: A case control study was done in Tikrit Teaching Hospital and Aldour city during the period from thirteen of june 2013 to first of October 2013.,The total number of cases was (100) diagnosed as malnutrition ,70 of them was anemic . Another 100 normal weight children of same age was taken as control ,54 of them was anemic. The age of the children included in this study was between (2) months and (5) years. Blood film examination was done to all children included in this study (malnourished and control cases ). Also the clinical signs and symptoms of malnutrition was assessed for each child ,which include the mid upper arm circumference, weight per height ,weight per age, height per age and occipito-frontal circumference
Results: The study revealed that there was a significant relation between the age of children and the malnutrition in which most of cases were under six months of age in malnourished cases(48,6% ), and there was significant relation between the types of feeding and malnutrition in which most of cases were on mixed feeding in malnourished cases(37,1%) versus (9,3%)in control cases, and there was a significant relation between the(mid upper arm circumference, occipito-frontal circumference) and malnutrition
Conclusion: There was a significant relation between the the level of MCV,MCH and MCHC in malnourished cases in comparison to control cases.

Background Many international studies have discussed the important of serum ferritin and other iron status as a risk marker in coronary artery disease(CAD). Aim: is to assess the effect of serum iron, total iron binding capacity(TIBC) , and serum ferritin on coronary artery disease (CAD) and their relationship with other risk factors.
Patients and Methods a case control study carried out from November 2016 and for 3 months duration enrolled on 96 male with age over 35 years,48 healthy men without (CAD) as control and other 48patients attending in Tikrit teaching hospital suffering of (CAD).All participants were assessed physically examination like blood pressers measurement, Wight and height. Then, the blood collected after 14 hours for measurement lipid profile , serum ferritin, serum iron, and total iron binding capacity (TIBC).Data analyses done include, t-test , chi-square test, and one-way ANOVA.
Results revealed that significant difference was found among the controls and CAD patients regarding the occurrence of BMI, blood presser(Systolic and diastolic) and fasting blood sugar were high significant in CAD patients as compared to normal healthy controls. However, significant differences was not observed in age groups. Regarding to Lipid profile(TG ,LDL-C and HDL-C ) . LDL-C and TG were high significant in CAD patients as compared to normal participants controls, while HDL-C was low significant in CAD patients as compared to normal healthy controls. About iron state ,it is evident that significant with Hemoglobin and TIBC at level p<0.05. No significant differences of serum ferritin were observed between CAD patients and controls, while become significant when assocated with other risk factors like obesity, hypertension, diabetes mellitus, and low LDL-C, but not with other parameters such as high TG , low HDL-C,high LDL-C, low TIBC,smoking and low exercise. Conclusion: Study concluded that serum ferritin might serve as risk factor for coronary artery disease when associated with other risk factors like obesity, hypertension, diabetes mellitus,and hyperlipidemia.

Background Nomophobia (no- mobile- phobia) by definition is the fear of being without mobile phone contact. If a person is in an area of no network, has run out of balance or even worse run out of battery. Nomophobia symptoms include physical side effects as panic attack, shortness of breath, dizziness, trembling, sweating, increased heart rate, chest pain and nausea. In recent times the cell phone transformed from a status symbol to a necessity as a result of the countless uses, a mobile phone provides personal diary, email dispatcher, and music player, camera, game player, calculator, video, and other programs. Aim: The goal of this study is to assess the nomophobia characteristics of students in Tikrit medical college.
Patients and method: A cross sectional study was conducted in Tikrit University College of Medicine from the 1st of January 2016 to the 1st of April 2016. The study included 180 students (86 were males and 94 were females) from Tikrit medical college. Samples were selected by simple random sampling from first to sixth grade. The data was collected by using a questionnaire which was administered by the students themselves after taking Permission from them.
Results: results shows that 79 (84%) of females and 70 (81.4%) of males check their phones always. 70.9% of males and 70.2% of females use their phones for contact with family, 59.3% of males and 52.1% of females for social network, and 52.3% of males use their phones for medical apps while only 35.1% of females use it for this purpose. 50 (58.1%) of males and 68 (72.3%) of females keep their phone at head while sleeping. 46 (53.5%) of males don't keep their phones silent while sleeping, while only 35 (37.3%) of females do the same.
Conclusion: The symptoms of nomophobia is highly frequent among medical students, about 58% among males and 79% among females.
Recommendations: The study recommend to achieve more studies on the signs, symptoms, and side effect of nomophobia. Develop more programs and articles for young people on the correct use of smart phones and the disadvantages of wrong use of these devices.

Background The role of infectious diseases in recurrent miscarriage is not clarified yet, but proposed an incidence of 0.5–5%. There are some candidate infectious diseases such as Listeria monocytogenes, Toxoplasma gondii, rubella, herpes simplex virus (HSV), measles, cytomegalovirus, and coxsackie viruses. Aim: This study was aimed at evaluation of the relation of TNF-α level in aborted women infected with bacterial vaginitis.
Material and Method A cross sectional study was carried out in Kirkuk city from the beginning of February 2018 to the end of May 2018, deep vaginal swab was collected from 100 women with recurrent abortion and 50 pregnant women (as control group) that belonged to different geographical areas in Kirkuk city and admitted to Kirkuk General Hospital. The swabs samples were cultured on blood agar and MacConkey agar for 24 hour and secondary cultures were done for resulted culture for isolate specific bacteria. Five ml of blood was collected from each women enrolled in this study for TNF-α test using ELISA technique. Results The study showed that 57% of women with recurrent abortion have positive high vaginal swab (HVS) culture comparing with 48% of pregnant women (control group). The current study showed that 86% of women had aborted in the 1st trimester of pregnancy and the least rate of abortion was in the 3rd trimester. The study showed that 52.25% of aborted women were belonged to the age group 27-36 years and highest rate of isolated bacteria from the HVS culture of aborted women was S. aureus (45.61%) while Proteus spp. was not isolated from aborted women. The study found that the highest mean of TNF-α level was denoted among women with abortion comparing with the control group (26.79±9.4 v.s 9.236±0.6 pg/ml) with highly significant relation of TNF-α level with abortion. The study showed that the highest TNF-α mean levels was recorded among women who aborted in the 1st trimester (28.75±8.76 pg/ml) and the lowest mean was noted among the 3rd trimester aborted women with highly significant relation among the groups.
Conclusions It was concluded that the there was a highly significant relation of TNF-α level with abortion specially with women suffered from bacterial vaginosis.

Background Papillomavirus is genera of the family Papovaviridae. The papilloma virus yield in their host benign skin tumors. The greatest common genital lesion produced by HPV infection is the benign genital wart (condylomata acuminata). Types HPV-6 and -11 are the main types associated with these lesions. This wart is distributed throughout the female genital tract on the cervix, vaginal wall, and vulva and perianal region. The importance of genital warts is its relation to the risk factors of cervical carcinoma, so perfect genotyping is essential in the management of these patients. In addition, the finding of premalignant lesions of the cervix is also essential in the management and this can be done easily by cervical pap smears. Aim: HPV genotype in patients with genital warts by PCR technique and the identification of the relation of genital warts with pap smear results in women from Nineveh Governorate.
Materials and methods: the current study a cross sectional was performed over 12 months period from June 2013 through June 2014, with a total of 551 cervical/Pap smears test were collected of women seeking gynecological advice for different complaints attending the major three hospitals in Mosul city, the ages between 11 and 76 years, with a mean age of 38.4 years. Chi-square test of independence; were designed for two catigoral variables. P- values ≤ 0.05 were taken into account statistically significant all over data analysis. The other part of the work including the HPV DNA tests which were applied by the PCR technique (by HPV Direct Flow Chip for in vitro detection, Master Diagnostica Kit, is aimed at simultaneous screening and genotyping of 36 HPV genotypes, High risk-HPV and low risk-HPV by PCR, after that reverse dot blot automatic hybridization, based on DNA- Flow Technology (e-BRID System)
Results: The cervical pap smears results of the women were classified according to Bethesda system into two groups. The largest No. of the results was negative intraepithelial or malignancy (NILM), 452/551 (82.03%), while the cervical epithelial abnormalities (EA) in the other group was 99/551(17.97%) women. The highest rate of cases with cervical EA cytological results was found in women with non genital warts (93.94%). The rate of cervical EA in women with genital warts compared to no warts, were 6.06%. The infection of HPV was representing 17.96% same as the percentage of cervical EA results. There were three categories of genotypes for HPV in cervical EA: low risk-HPV, high risk-HPV, and mixed infection (low and high risk-HPV). All cases had history of genital warts in the present study were positive for HPV100% (6/6). Different HPV genotypes found in the present study, five distinct HPV genotypes were detected in genital warts which were HPV- 6, 11, 16, 18, 31. The predominant type in genital warts to HPV-18 3/6.
Conclusion: From present results it can be concluded that; 1- the rate of HPV infection in Nineveh women suffering from genital warts were 6/6 (100%). 2- the most predominant HPV genotypes commonly related with genital warts were the high risk HPV predominantly genotype HPV-18. 3- the relation between genital warts with pap smear results were non- significant p=0.5.

Background Worldwide, malnutrition is common and is responsible directly or indirectly for about a third of all deaths of children under 5 years of age. Primary malnutrition also continues to occur in developing countries as a result of poverty, parental neglect or poor education. Specific nutritional deficiencies, particularly of iron, remain also common in developing countries. Restrictive diets may be iatrogenic as a result of exclusion diets or parental food fads, or may be self- inflicted.
Aim of The Study: This study was done to determine the role of Head to Chest Ratio as screening test in early detection of malnutrition .
Patient and Methods: A case control analytic study was done on children attending the pediatric department , and Nutrition Department in Kirkuk Pediatric General Hospital from 29th of March 2015 to the last of August 2015. The study included 150 malnourished children (study cases) and 100 control children (control cases) , their age from (2months -5years). Each child included in the study was assessed by a prepared questionnaire. Screening done by measuring Weight for age, Height for age, Occipitofrontal Circumference for age, and Mid-arm circumference , chest circumference and the diagnostic test weight for height.
Results: The total number of cases 150 study cases (63% boys and 37% girls )and 100 control cases(65% boys and 35% girls). All the malnutrition cases looked wasted (100%) followed by pallor(48.7%) and looking ill(44.7%).Anthropometric measures Weight/age sensitivity(73%) and specificity(75%), Mid arm circumference sensitivity(75%) and specificity (79%) , Length/Height for age sensitivity (30%) and specificity(18%) .Head circumference in males sensitivity (1.4%) and specificity(78.3%) and Head circumference in females sensitivity (100%) and specificity(10%) , Chest circumference in males sensitivity (92%) and specificity(30%) and Chest circumference in females sensitivity (87%) and specificity(20%) ,Head: Chest Ratio in males sensitivity (93%) and specificity(26%) and Head :Chest Ratio in females sensitivity (92%) and specificity(25%) .
Conclusion: Finally the present study concluded that still Mid arm circumference is the most sensitive and specific method for screening of the malnutrition .Head to Chest Ratio is a good method for early detection of malnutrition all thought it is more sensitive and less specific than Mid arm circumference..

Background Diabetes mellitus is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. Death may result from acute metabolic decompensation.
Aim: To evaluate the level of plasma fibrinogen in diabetic patients type 1 and compare the results with the normal subjects and to estimate the effect of glycemic control and the duration of the disease on the level of plasma fibrinogen. Patients&Methods: This study was conducted on fifty patients, having type 1 diabetes mellitus DM and were insulin dependent. All the patient were attending the National Diabetes center, Al-Mustansiryia University, from February to April 2010.
Results: This study was conducted on 50 patients all with type 1 diabetes mellitus, they include 30 female and 20 male ,with female/male ratio was 1.5/1 ,the age range of patients among 1-20 years ,also included a control group of fifty, age and sex matched, normal healthy volunteers, had no family history of diabetes.
Conclusions: By comparing the coagulation parameters in diabetic and control subjects there was a significant increase in plasma fibrinogen in diabetic patients ,also there was improvement in fibrinogen level with glycemic control in patients with type 1 diabetes mellitus, thus will modulate the hypercoagulable state associated with this disease, plasma fibrinogen level is unaffected by the duration of the illness and sex of patients.

Background Local anesthesia in hemorrhoid or anal surgery has a reputation for being a painful and risky procedure.
The aim of this study is to determine efficiency and safety of this method of local anesthesia.
Patients & Methods : 60 patients with hemorrhoids underwent surgery under local anesthesia compared to 70 patients under general anesthesia from February 2009 to July 2011.
Effectiveness of anesthesia per-operative monitering, post-operative analgesia and analgesic requirements, post-operative urinary complications.
Results: Of our patients 73.3 % showed optimal analgesia 25 % showed satisfactory analgesia,1.6 % showed poor analgesia and non was converted to general anesthesia.
Concerning post-operative pain a valid analgesia last from 40—180 (mean 96 ) minutes for local anesthesia group and 20—40(34 ) minutes for general anesthesia group. No local or systemic complications were observed during or after surgery that could be attributed to the anesthetic mixture.
Conclusion: This method appears to be well tolerable, safe and effective, reduce hospitalization and cost and can be considered as a day clinic procedure.

Background The cervical Pap smear test is a standard screening procedure used for cervical cytology testing for the diagnosis of premalignant and malignant cervical lesions
.The risk factors for cervical cancer are early age at first intercourse, multiple sexual partners, nutritional status, hormonal changes, parity, host immune status, smoking, viral oncogenic Human Leukocyte Antigens (HLA) types and coinfection with other viruses such as human immunedeficiency virus-1 and herpes simplex
virus. Aim: is to study the relation of some of the marriage variants as risk factors for cervical cancer with abnormal Pap smears results for women in Nineveh governorate. Materials and Methods: A cross-sectional study was carried out on patients' women attended the Obstetric and Gynecological Mosul Hospitals for the period from June 2013 through June 2014, after the collection of data through direct meeting and a questionnaire comprising patients' characteristics and the results of Pap smear. Five hundred fifty one Pap smears were collected from women between the ages of 11 and 76 years. The personal characteristics of women included the mean age at 1st marriage which was 18.9 years; 18.8 years mean age of duration of marriage, and mean age at 1st delivery as 20.3 years. Other features included the sequences among wives or husbands which were found to be higher in 1st sequence (who had one husband or those who her husbands never had another wife): 464, 84.21% and 508, 92.20% respectively.
Results: abnormal Pap smears were 99/551(17.97%). A significant relation were observed between abnormal Pap smear in highest percentage at age (25-45) years 51.52% (P=0.032), and mean age at early forty 41.6± 12.21(P=0.002). The highest rate of women with epithelial abnormal Pap smears results were 1st sequence among wives and husbands (79.80% and 91.92% respectively). The mean ± SD of women with epithelial abnormal Pap smears were 18.3 ± 4.66 years of age at 1st marriage, and 19.7 ± 4.90 years of age at 1st delivery. Non-significant relation was detected between abnormal Pap smears and each of (the sequence among wives or husbands, age at 1st marriage, and at 1st delivery). Mean ± SD of women with epithelial abnormal Pap smears results were 21.1 ± 12.41years of duration of marriage, and there was significant effect for duration of marriage by using the same test between the two mean ages (P=0.028).
Conclusion: the age, and duration of marriage were strongly related to abnormal cervical Pap smear results, while age at 1st marriage , 1st delivery , sequence among wives or husbands were not related with epithelial abnormal cervical Pap smear in Nineveh governorate women

Background Ovariectomy induced estrogen depletion, which affected bone healing and remodeling. Calcium closely tied to magnesium and phosphorus regulation.
The aim of the study was to find the effect of bilateral ovariectomy on femur bone tissue in sexually mature female rabbit and on calcium magnesium and phosphorus level.
Subjects and Methods: Forty- eight sexually mature female rabbits were used and divided in to 6 groups; control, groups A, B, C, D, E. Bilateral overctomy was made on the experimental groups. The overictomized groups were scarified at the interval of zero, 7, 14, 30, 60 and 90 days. Blood samples were taken from the experimental animals twice, one was before the overectomy operation and the sconed was at the end of experimental time and before scarifying the animals. Blood samples were centrifuged and serum was obtained and then tested for calcium, phosphorus and magnesium levels. Femur bone was also taken and prossed for H&E staining method. Highly statically difference was found between the control and groups D&E and no significant difference with group A&B in calcium level .phosphorus levels showed difference between the control and the study groups magnesium showed no difference between the control and group A, but statically difference with group B and highly significant deference with groups C,D and E.
The result with the femur bone showed no major changes between the control and groups A&B,while in group C resorption cavities appeared clearly. In group D multiple wide vacuoles or resorption cavities was clear .Group E showed osteoporotic changes with wide resorption area were obvious. It is clear from the present result, that OVX had osteoporotic changes on femur bone increased with time in association with calcium level decrease. The effect was minor with phosphorus and less pronounced with magnesium.
In conclusion of this study found that OVX is associated with calcium serum level decrease but not fast more than one month after OVX, the phosphorus level declined in rapidly after OVX then gradually rises up again in other groups, for magnesium showed no statistically significant difference.

Background Toxoplasmosis is a parasitic disease caused by the an obligatory intracellular protozoan Toxoplasma gondii, which is widely distributed around the world . Infection is acquired by ingestion of viable tissue cysts in meat or Oocytes excreted by cats that contaminate food or water. Congenital transmission may occur when an uninfected mother acquired primary infection during pregnancy.
The aim of this study was to determine the seroprevalence of Toxoplasma gondii among pregnant women in Tikrit city-Salahaldeen Province. Pateints & Methods: Blood samples from 290 pregnant women were collected. Samples were collected during the period from October 2010 to July 2011. Serum was separated and tested for T. gondii IgG and IgM antibodies using a chromatographic immunoassay.
The Results The seroprevalence of IgG antibodies to T. gondii was 30% while IgM was 20.68%. The seroprevalence of T. gondii increased with age, the highest IgG and IgM were among participants aged (36 – 45) years 40.74% and 30.55% respectively. The analysis showed that the seroprevalence of Toxoplasmosis is positivity correlated with the age, pregnancy trimester and the occupational of the women The conclusion of this study the women in their 1st trimester of pregnancy were significantly at high level of infection with T. gondii 32.08% and 22.44% of IgG and IgM respectively, while in the 2nd trimester showed the same result to some extent for IgG 32.25%, but showed low rate for IgM 9.67% in the same trimester while no recorded any infection in 3rd trimester in the study.

Background Physiotherapy is a branch of internal medicine , radiation therapy is one of the most important treatment in this branch . in study we used infrared radiation and microwave diathermy in treatment of severe neck and upper back , muscle spasm, It occur during involuntary contractions of muscle and causes pian,discomfort in the muscle. Disc problems (disc herniated ) in cervical it is the main causes of sever neck and upper back muscle spasm and lead to severe pain difficulty in movement. The aim of this study is to assess and comparing the effects of infrared radiation with microwave diathermy in sever neck and upper back muscle spasm treatment.
Patients & Methods: This study was done in physiotherapy department in Azadi hospital in Kirkuk city for patients with severe neck and upper back muscle spasm due to acute and chronic disc problem (disc herniated).The study included 60 female patient age between 35-55 years and weight between (58-68kg). ) , these patients divided in two groups each group included 30 patients prepared for physiotherapy treatment.The first group for infrared treatment and the second group for microwave diathermy treatment..
The Results The results showed the percentages of patients responsibility for infrared and micro wave diathermy treatment ( 100% , 66.6%) in four physiotherapy session for infrared and micro wave diathermy treatment respectively. Conclusion: The infrared radiation more effects than microwave diathermy in treatment of severe neck and upper back muscle spasm in non-contact instrument practice due to microwave reflection at air –skin interface and this effect in microwave skin and under the skin penetration ability because of the loss in radiation.

Background Progestational agents, such as megestrol acetate and medroxyprogesterone acetate, are effective hormonal treatments for metastatic breast cancer in postmenopausal women.
The aim of this study is knowing effect the progestational agent(only pills),(depto medroxyprogesteron) (DMPA) in some biochemical parameters (TOtal protein, globulin, ALP, TSB, uric Acid, creatinine, and lipid levels (Triglycerides, Cholesterol) in the woman.
Patients & Methods: This study included ( 100 ) samples of women used progestational agents in (Clinics) (20) blood samples pulled from healthy women as Control sample. The study has carried out in Clinics from (March 2017) to (September 2017).. The samples were divided into three groups; the first group: - (40) women used a progesterone only pills (POPs) the second group: -(40) women used Depot medroxyprogesteron acetate injection(DMPA). The third group was the healthy women(control).
The Results: The results of the study indicated a significant decrease in the Concentration of the Total Protein and Globulin levels at level (P <0.001) and there's no significant differences in activity ALP and TSB Concentration at level (P <0.001) The results revealed a significant decrease in the Concentration of the Uric acid at level (P <0.001) and a huge increment in the Concentration of the creatinine at level (P <0.001) in approach to the healthy group. while the results showed a rise in the concentration level of Cholesterol, Triglyceride when compared to the healthy group.
Conclusion in this study there are significant decrease in the concentration of the Total protein, Globulin ,uric acid and increase in the concentration in the creatinine when compared to the healthy group, While there are arise in the concentration lipid levels(Triglycerides, Cholesterol)when compared with healthy group