The Medical Journal of Tikrit University

Placentae from 50 pregnant women were collected from Albatool Obstetrics and Gynecology Teaching Hospital in Mosul-Iraq. Thirty of them belonged to anaemic pregnant women associated with intrauterine growth restriction (IUGR), while the other 20 belonged to uncomplicated pregnancy (as a control group). The parameters studied were mean gestational age, birth weight of babies, mean placental weight, diameter, surface area, and mean placental volume. The main findings in the placentae from anaemic women were compared to the control group.
Results reveal that there is a significant decrease in mean birth weight, mean placental weight, diameter, surface area and mean volume of the placentae in anaemia of pregnancy group associated with IUGR as compared with control group.
Alterations in various parameters may be due to compensatory phenomena to fulfill the demand of O, to fetus, subsequently affecting the growing fetus. Appropriate precautions if taken during pregnancy, complications due to anaemia can be reduced.
In conclusion, this study demonstrated that severe anaemia in pregnant women alters the placental morphology, leading to fetal growth restriction and prompt treatment of anaemia must be taken to improve placental growth and a favorable obstetric outcome.

Background: Benign prostatic hypertrophy (BPH) is a condition in which the prostate becomes enlarged as part of the aging process. BPH Primarily affects men over the age of 40, of all races and ethnic backgrounds. No one knows specifically why an enlarged prostate occurs. However, hormones and genetics may play a role in the condition's development some researchers believe that it may be related to a drop in testosterone levels as men age. Others believe that one enlarged prostate cause is the reawakening of cells that deliver signals to other cells in the prostate.
Objective: To evaluate the relation between serum prostatic specific antigen (PSA) and dihydrotestosterone (DHT) on the effects of 4 weeks of solifenacin therapy for BPH patients.
Patients and Methods: A total of 108 patients attending the consultation department at Tikrit teaching hospital were enrolled in this case control study during the period from Novemberl®, 2011 tol™ of August, 2012. All patients had BPH with al- blocker treatment during the study period, a change in type and dosage of al-blocker was not allowed, Solifenacin (Smg) once daily dose was administered to the patients for 4 weeks.
PSA level, serum DHT, IPSS, post voiding residual PVR, and prostatic size were measured before and after treatment. The patients themselves serve as their own control group. Estimation of Serum DHT and serum PSA using Elisa kit.


Results: The relationship between PSA level and prostate size is probably the most natural reason for the correlation of urinary symptoms and serum PSA level .also found age and Higher serum DHT concentration were associated with larger prostate volume, elevate PSA level, less response to solifenacin. In the present study, strong direct and significant relationship found between storage symptom, voiding symptom and total IPSS with DHT level for men who treated with solifenacin +a- blocker than men who take a-blocker alone. While clarified non-significant differences found between PVR and the use of solifenacin +a-blocker and prostate size.
Conclusion: Serum PSA and DHT can be used to predict effect of solifenacin on BPH after al-blockers monotherapy.

Aim. Although inguinal hernia repair is one of the most frequently performed surgical procedure worldwide, the ideal repair still not accepted yet. Aimed that Lichtenstein hernia repair method, non-fixation technique can be used safely with better results in term of reducing operative time and pain.
Materials and Methods. The study included 85 patients who referred to the surgical outpatient clinic of Tikrit teaching hospital and all of them underwent Lichtenstein hernia repair.
The standard procedure done in 42 patients (group A); while the non-fixation technique used in 43 patients (group B). All patients were followed and examined for pain, scrotal edema, and the presence of seroma in the 7th postoperative day and for paresthesia, neuropraxia, and recurrence in the 6th postoperative month.
Results. Operative time and pain scores in the non-fixation group were significantly lower, the operative time was significantly shorter in group B (P = 0.001), and the VAS scale was higher in group A (P = 0.001), without any increase in rates of recurrence.
Conclusion. Based on these findings, in Lichtenstein hernia repair method, non- fixation technique can be used safely with better results.

In recent years, accumilated data indicate that "anti-mullerian hormonme (AMH)" reflects the number of follicles that have made the transition from the primordial pool into the growing follicle pool, and that is not controlled by gonadotropins. ~Ovarian reserve tests would be considered incomplete without AMH measurement. The study hypothesis aimed to answer a question: Is there a correlation between recurrent unexplained pregnancy loss and diminished ovarian
reserve as reflected by serum level of AMH? sixty three non-pregnant female (34
females with history of unexplained three or more pregnancy losses within the last 5 years and 29 multiparas females without history of recurrent miscarriage as control). twenty six (41%) of the whole women included in the study had normal AMH while 22 (35%) of them had low and just 15 (24%) recorded high levels. Sixteen (44%) of women >35 year had low AMH compared to just 6 (22%) in women <35 year which was significantly different. Only 6 (17%) of those >35 year old had high AMH level. AMH level between women in cases and control showing that overall women with recurrent miscarriage had statistically significant lower AMH than in women in the control group (50%) and (17%) respectively. Although young women <35 years old in cases had lower AMH level (27%) compared to those in control (8%) but the difference was statistically not significant. In women > 35 years old AMH levels were significantly lower in cases (68%) than in control (23.5%), even after adjusting for age .Four women (35.5%) in the control group had high AMH level while only one of women in cases group recorded such level.

Lung Cancer is one of the leading causes of cancer deaths in the U.S. It is expected that about 180,000 new cases will be diagnosed within the U.S. this year, and of these, about 160,000 people will die. While the incidence of lung cancer has been declining in men since the 1980s, it is still rising in women. The most well known risk factor for lung cancer is cigarette smoking (which has been linked to 85 to 90 percent of all cases). Other well known risk factors include exposure in the workplace to certain substances (including asbestos and some organic chemicals), radiation exposure, radon exposure (especially in smokers), and even second-hand environmental tobacco smoke. Because of the close associated of lung cancer with cigarette smoking, It is expected that this strong risk factor possibly overwhelm blood type differences.

Neonatal sepsis is the leading cause of morbidity and mortality in neonates if developing countries, intervention trials showed that using Pentaglobin in neonata sepsis decrease morbidity and mortality.
Patients and Methods:-
The study included 100 patients sustained neonatal sepsis, (age 0-30 days), fifty patient were treated with antibiotics only, and the remaining 50 patients were treated with antibiotics and pentaglobin as an adjuvant therapy.
Results:-
The study showed that improvement occurred when treatment included (Pentaglobin) i 74% compared to 38% in case of treatment with plain (antibiotics) with a relative risk o 1.95.
Conclusions:-
Pentaglobin is useful in the management of neonatal sepsis.
Recommendations:-
Pentaglobin may be added to the (antibiotics) in the management of neonatal sepsis further studies are required to determine the cost effectiveness.

The aim of this study was to assess the medical treatment in the management of primary grade-4 internal hemorrhoidal disease (IH) and external hemorrhoidal disease (CH).Detailed history and proctoscopic examination to determine position, size, and degree of hemorrhoids was conducted in all patients attending our private clinic and Salah Aden General hospital .The study was conducted over a one_ year period. All were started on Daflon, with dosage of 6 tablet per day for 4 days, 4 tablet per day for 3 days, and 2 tablet per day until the signs and symptoms clinically disappear or the end of observation time of 2months were followed up weekly during the study period and proctoscopic examination was conducted at each consultation.
Results: The mean age was 35 (range 20 60) years. The majority (58%) suffered primary grade IV internal hemorrhoidal disease and 42% with external hemorrhoidal disease. 56%patient had an excellent improvement,28% good,12%moderate and 4% nil.
Minor side effects of Daflon (mainly gastrointestinal symptoms) were encountered in 8% patients.

Urinary tract infection(UTI) is consider as a common infection and in spite of the availability of antibiotics, UTI has become difficult to treat because of the increasing resistance of pathogenic bacteria to antibiotics .This research was done to detect the uropathogens of urinary tract in individuals attending Tikrit Teaching Hospital (T.T.H.) . complaining from UTLThe present study was carried out from November 2013to February 2014 and 63 urine samples were examined 29 were from males and 34 from females, from those 81% has a positive culture, while 19% was negative. Also, the current study appeared that females were more frequently effected than males, and the most common isolated bacteria was Pseudomonas aeruginosa, while the less isolated one was the Enterococcus. Using 10 tested antibiotics, the best acting antibiotic was the Amikacin, while the less effective antibiotic was the Ampicillin.

Back ground :
A thrush is a yeast infection of the mouth that is caused by a fungal microorganism called Candida albicans. Oral thrust is most common in infants and is generally not a serious condition in itself. 50% of the population has candida in their mouths. Under normal circumstances Candida albicans is kept under control by bacteria. Candida albicans can also cause a yeast or thrush infection in the vagina, resulting in the exposure of an infant to the infection during the vaginal birthing process. It can also cause an infection in a woman's nipples, which can then be transmitted to an infant's mouth during breast feeding. Thrush appears as whitish, velvety lesions in the mouth and on the tongue. Underneath the whitish material, there is red tissue that may bleed easily. The lesions can slowly increase in number and size.
Objectives of the study: To determine the epidemiological factors of infant oral candidiasis among infant attending Tikrit teaching hospital out-patient clinic.
Patients and methods: A descriptive study was conducted on infant attending Tikrit teaching hospital. The sample includes (115) infants. The information was obtained according to well-prepared questionnaire. The demographic information in addition to other epidemiological data was obtained by the interviewing with infant mother. The study period start from 1/2/207 to 1/4/2017.
Results:
The results of current study showed that more than (61%) were males and more than half of the cases within the age first three months. About (98%) of cases with low level of maternal education. Regarding delivery method of infants, it has been shown that (46%) by cesarean section. A maternal history of birth canal infection was about (59%) and a maternal history of breast infection was (18%). Artificial feeding of infant cases were (43%).
Conclusions: Thrush of infants is prominent in 1% three months of age and it is more frequent with those of certain risk factors as maternal breast and birth canal infection..

The paradigm of pathogen-driven neutrophil apoptosis is exemplified by the Pseudomonas aeruginosa toxic metabolite, pyocyanin that induce a dramatic acceleration of neutrophil apoptosis in Cystic fibrosis lung disease. Whether the course of pyocyanin- induced neutrophil apoptosis can be modulated or not by bacterial cell wall product present significantly in inflammatory foci is unknown.
Materials and methods : Purification of neutrophils and preparation of exotoxin pyocyanin, bacterial sonicate and LPS-HE were performed according to many standard methods. Apoptotic neutrophils were identified microscopically based on morphological changes characteristic of apoptosis.
Results: Pyocyanin-induced neutrophil apoptosis was significantly delayed at earlier time points of 6 hr. in the presence of bacterial sonicate recording of a neutrophil apoptosis rate of 24.8% when compared to 42.3% of apoptosis in the absence of bacterial product. Combinatorial preincubation of LPS-HE with sonicate cell wall product more decreased synergistically the apoptotic rate to reach 17.1% at the same time point of treatment. Conclusions: Our findings suggest that bacterial sonicate most probably cell wall components are an antiapoptotic stimulus for delaying pyocyanin-induced neutrophil apoptosis in vitro, thereby may contribute to attenuate the neutrophilic inflammation in lungs of Cystic fibrosis patients.

Background: Undescended testis is a well recognized clinical problem in infants and young male, as well as being a frequent finding in adult individuals .

Aim of work : To compare the results of MRI and ultrasound in the localization of undescended testis , in order to choose the line of treatment.

Method : The study was conducted in two general hospitals in Baghdad between Oct. 2012 --- April 2013. Forty male patients with undescended testis ( 6 months ---20 years ) underwent abdominal and pelvic MRI as well as inguinal and pelvic U/ S to identify testicular location , findings were reviewed by three observers independently and compared with surgical and / or clinical follow up study.

Results : Ultrasound succeeded in localizing 21 cases of undescended testis with sensitivity 83.3 % specificity 100% and accuracy 90 % . On the other hand MRI was able to demonstrate 24 cases with sensitivity 96%, specificity 100% and accuracy 97.5 % . Conclusion: Magnetic Resonance Imaging is a useful imaging tool in the localization and

tissue characterization of a undescended testis, especially with the use of i.v contrast injection which is helpful in suspected cases of testicular atrophy and cases of abdominal and pelvic testis, however, ultrasound must be the first line of imaging investigation as it is readily available and fast, but highly operator dependent .

Ovarian cysts are fluid filled sacs inside the ovary that are common in women during their reproductive years. Most functional cysts can be managed conservatively and disappear spontaneously whill Surgical intervention is usually required when an ovarian cyst presents with acute symptoms.

To study the relation of cyst to body mass index and to estimate the types and method of intervention with signs and symptoms of patients:

ninety —four women that were diagnosed with ovarian cysts and were treated at the department of obstetrics and gynecology in Tikrit Teaching Hospital were enrolled in the studyfrom 2010-2013.

it was founded that 59.6% of patients from age group 15-30 years. Most or patients from urban which account about 63.8% and 59.6% were housewives ,it was founded that 40.4% had having MBI more than 30 figure .It was founded that 40 case from the total study patients (94) the cyst site were at left side :59.6%( 56/94) were cyst. From the study finding about 46.8% of patients the main presenting symptom was amenorrhea. It was found that 59.57% of cyst size was below 5 cm and only 4,26% was measured more than 10 cm and removed or laparoscopy while no rolled for medical treatment in such size.

Ovarian cyst is consider a major public health problem which have a variety of clinical presentation and need many method for management according to the size and site.

Two intestinal cestodes were chosen to make a compares, considering some aspects of energy metabolism; Ophiotaenia bofonis habitat small intestine of the house frog Bufo viridis viridis, and Cotugnea columbae habitat small intestine of the domestic pigeon Columba livia domestica.

The present study reviled that concentration of macrobiomolecules , the energy raw materials, in O. bofonis is higher than that of C. columbae. There were significant differences at p<0.05 between the concentration of total carbohydrates, protiens and lipides: (240, 181 pg/ml and 196mg/100ml, respectevely in the pigeon cestode and 105, 53 pg/ml and 133mg/100ml, respectively in the frog cestode).

High performance liquid chromatography technique (HPLC) analysis for fatty acid elucidated that each of the two helminthes contain six types of fatty acid. O. bofonis found to have three saturated fatty acids: stearic, palmatic and myristic, 2.72%, 2.29% and 0.89% respectively and 7.91%, respectively. On the other hands, C. columbae found to have four saturated and three unsaturated fatty acid: linoleic, linolienic and oliec, 73.13%, 13.07% fatty acid: stearic, palmatic, myristic and caproic, 51.43%, 45.89%, 2.38% and 0.19% respectively, and two unsaturated fatty acides: linoleic, linolienic, 0.09% and 0.06%, respectively.

Enzymatic study pointed to the significant differences at p<0.05 between the enzymes activity in frog cestode and that of pigeon cestode. Activity of GGPDH and LDH (cytosolic enzymes) and SDH and FR (Mitochondrial [U/L, 130 nm FAD/min/ mg protien and 198 nm NADH/min/mg protien in O. bofonis respiretory enzymes), were :7.514 U/L, 56 extract; and 7.514 U/L, 56 IU/L, 130 nm FAD/min/ mg protien and 198 nm ADH/min/mg protien in C. columbae extract.

The prevous resultes may reffered to a relativly higher activity of the enzymes under study, those take a part in glycolisis and energy metabolism libration in O. bofonis than that in C. columbia, in spite of that the occumulated souces of energy were more aboundant in pigeon cestode.

Background: lifestyle: A way of living of individuals families (household), and societies, which they manifest in coping with their physical psychological, social and economic environment on a day to day basis. The health of an individual is due in part at least to [his/her] own lifestyle and behavior. In turn, lifestyles and behavior in the general public are influenced to some extent by medical advice. It is therefore of education interest to examine the lifestyles of today's medical and students tomorrow's doctors who will be involved in future health care.
Aim of study: To show the difference of lifestyle between students of Medical college and Education college.
Subject and Methods: A cross sectional study conducted on (160) students of both Medical and Education College in (one medical and two Education College) . All the participants were given a self — administered questionnaire related to lifestyle and also asked to self — rate their stress [stress free, low, moderate, and high].
Results: The result of this study was (6.2%) of male medical college vegetarian (12.5%) of male medical college had snack between meals. (13.1) of male medicine college went to gym frequently. (22.5%) of male medicine college used internet daily. While (9.3%) of male Education college were vegetarian (17.6%) of male Education college had snack between meals. (14.3%) of male Education college went to gym frequently. (20.6%) of male Education college use internet daily. (6.8) of female medicine college were vegetarian. (14.3%) of female medicine college had snack between meals. (21.2%) of female medicine college never went to gym. (24.3%) of female medicine college used internet daily. While (8.1%) of female Education college were vegetarian. (13%) of female Education college had snack between meals. (16.2%) of female Education college never went to gym. (11.2) of female Education college used internet daily.
Conclusion: Tikrit university students showed different health behaviors regarding life style Presence of various modifiable risk factors such as unhealthy diet and irregular eating habits in especially in education college students.
Recommendation: The research recommended to hold educational sessions titled by "heath care" aim to educate the students about the benefit of physical activity and healthy diet.

Background: Toxoplasmosis is a serious problem of females during their reproductive period of life, so improving their awareness about the disease and preventive measures is very important in reducing and preventing toxoplasmosis.

Objective of this study was to assess the knowledge, practice and attitude among (15- 45) year old females in Tikrit city about toxoplasmosis.

Subjects & methods: This is a cross sectional observational study was conducted in Tikrit city from the period of 15th of November/2015 to 15th of March/2016 among females in Tikrit city. Sample size was 200 females were selected in a convenience sampling design. Data was collected by a self- administered questionnaire.



Results: knowledge was poor in 75.15% of females » 23.75% had moderate knowledge and only 1.1% had good knowledge, but they were having a positive practice of the preventive measure of the disease as 100% had good practice .The majority of women 89.51% didn’t perform toxoplasmosis test. Most of

their information was acquired from TV which was the source for 34.8% of women. Conclusion: Most of them were unaware about the clinical presentation and complications of the disease. Their preventive measurements practice were good

Cortisol hormone is a glucocorticoid hormone produced in the zona fasciculata of adrenal cortex, its secretion is regulated via HPA axis. The study was planned to determine serum cortisol level in infertile women attending family planning clinic in Azady Teaching Hospital in Kirkuk governorate. This case control study done on 60 infertile women and 30 fertile women in the same age range, the infertile women were divided in to two subgroups according their BMI. Sample collection was done by obtaining four ml of blood at 9 AM in the preovulatary phase from all study groups, serum cortisol were measured by using ELISA technique. The results of this study showed that serum cortisol level in infertile women were significantly higher than fertile women, also its concentration in obese infertile women was significantly higher than lean infertile women furthermore, serum cortisol level was significantly higher in infertile lean women in comparison to fertile non obese women. on conclusion both stress and obesity may have a role in elevation of cortisol hormone in infertile women.

Neural tube defects (NTDs) are a group of severe congenital abnormalities result from the failure of closure of anterior neuropore or neural fold .The pattern of inheritance of these complex defects is multifactorial, making it difficult to identify the underlying causes.
Recent studies have shown that the addition of folic acid (Vitamin B9) to the diet of child-bearing age women may significantly reduce although not eliminate, the incidence of NTDs.
Imaging tests may be used to help in detection of defects in the developing fetuses. These may include: Ultrasonography, MRI and CT scan.
During the period of the work, routine antenatal trans-abdominal ultrasound examination was made for 6720 outpatients’ women with missed period of 12-36 weeks in the private clinic during the period from september 2014 to october 2016 in Baghdad city.All patients are followed post deleivry. Thirty two patients were diagnosed as NTDs sonographically. Twenty nine cases were terminated according to the parent decision. Post-termination, MRI and CT scan was performed on 25 cases with anencephaly and encephalocele to show the extend of the brain tissue and the defect in the skull vault.
Blood sample from 200 pregnant women was aspirated in the laboratory for folic acid estimation. Pregnant woman who taking folic acid preconception were excluded, Among the cases 82.4% of them were with low folic acid level.
The frequency of NTDs in the present work was 0.47%, the majority of cases was anencephaly 17 (53%) followed by encephalocele 8(25%) and the spina bifida 7(22%).

The cross sectional study was determine the incidence rate of perineal pruritis after administered dexamethasone intravenously. The study was performed on 100 patients in age between 20-55 years (50 males and 50 females) in Tikrit city from 2-1-2014 till 2-1-2017
Result: The study was show the incidence rate of perineal pruritus in female is 80% and 60% in male
Conclusion: These study was
record the transient pruritus following
administration of intravenous dexamethasone sodium phosphate is a common.

Background: G6PD deficiency very common disease in our country with variable presentation (mysterious disease) with ingestion of fava beans was the most common cause.
Patient&method: Prospective study involving One-Handered Twenty Three cases of patient who were admitted to Emergency Room in AL-Elwia Pediatric Teaching Hospital and were diagnosed as G6PD deficiency between the 1* of February 2016 and 31% of May 2016.
Results: One Handered-One were males and Twenty-Two were females, , 66.7% were due to ingestion of raw fava beans and 33.3% were due to ingestion of cooked fava beans. Negative family history of hemolysis was found in 56.9% and only 4.1% had positive drug history without fava beans ingestion.Pallor and jaundice with dark urine were the commonest presenting features.Hematocrit level was < 20 in 83.8%. Blood film showed normochromic normocytic anemia in 95.9%, blister cells in 86.2% and fragmented cells in 11.4%, and 2.4% of patients showed spherocyte.Significant reticulocytosis ~was seen only in 84.6% of patients.Hyperbilirubinemia was universal in all the cases and renal function was normal in all cases.Some patient need more than one time blood transfusion.G6PD enzyme was deficient early in 76.4% of cases. All the patients recovered well after intravenous fluid or blood transfusion.There is No Death .
Conclusion:Boys were more affected than girls in terms of presentation and severity and intoxication with raw fava beans were more dangerous than cooked beans. Blood transfusion is the most used therapeutic measure

The study was carried out in Kirkuk city from May 1* to November 1% 2015. These patients admitted to Kirkuk Children Hospital and primary health care centers of Kirkuk first health care sector. The number of children with Ear infection was 221 patients whom their ages were under 5 years old. The control group included 50 children who appeared healthy and they have never used pacifiers in the past. Ear swabs were cultured for all the patients and control. 70% of ear-cultured specimens gave positive results. Most isolates were Staph. aureus with 31% . Strep. pyogenes 4% . Strep. pneumonia 6% and 9%. Pseudomonas aeruginosa were present in ear in about 10% of the isolates. M. catarrhalis was also found in 3%. Some members of enterobacteriaceae were also found such as (E. coli in 5%, K. pneumonia in 3% and 6%, while P. mirabilis was found in 5%). A member of (yeast-like fungi) Candida alpicans was also found in ear in about 11%. As for the use of pacifiers, it shows that 66% of the total patients were using pacifiers or dummies, While 34% of them were not using pacifiers at all. The aim of this study was to explore possibility to limit the use of pacifiers in children to prevent ear infection.
Conclusion : a possible connection may occur between the pacifiers use and ear infection due to the possible movement of the throat microbes through the auditory canal to the middle ear, which leads to otitis media infection.