Thi-Qar Medical Journal

Background: Uncontrolled hypertension is a major concern among hypertensive patients. It
may be caused by various factors such as inadequate knowledge and inappropriate attitude,
unhealthy lifestyle, and ineffective treatment.
Objectives: To estimate the prevalence and determinants of controlled hypertension status
among adults in Nassiriyah city.
Design, Setting, and Participants: A cross sectional household survey was carried out in Thi
Qar Governorate, Southern Iraq, on 2148 adults (410 of them were known cases of
hypertension) from two areas in Nassiriyah city, aged 18 years and above, recruited between 1st
of November 2012 and 31stof October 2014 using multistage sampling.
Main Outcomes and Measures: Controlled hypertensive patient was defined as an individual
with self-reported treated hypertension with blood pressure measurements of less than
140/90 mmHg. Determinants were measured using a questionnaire -based interviewing.
Results: The overall prevalence of hypertension was 26.5% (19.1% were known hypertensives
and 7.4% were unrecognized hypertensives).Of the recognized hypertensives, only 35.4% (95%
CI 31.0%-39.8%) were with controlled blood pressure. The uncontrolled hypertension
subcategorized into those of isolated systolic and isolated diastolic blood pressure with a
prevalence of 6.8% and 4.0% respectively. Significant independent association was found
between control of hypertension and age, occupation, BMI, educational level, feeling of
irritability, family history of hypertension, physical inactivity, drug intake and type of drinking
water.
Conclusion: The prevalence of uncontrolled hypertension in Thi-Qar Governorate was high. This
necessitates effective preventive and control measures.

Background: Hypertension was reported to be approximately twice as common in
persons with diabetes as in those without diabetes.
Objectives: To estimate the prevalence of hypertension and pattern of blood
pressure among patients with type 2 diabetic patients in Basrah.
Methods: This cross-sectional study was conducted on a convenience sample of 185
type 2 diabetic patients attending the Diabetic Center in Al-Fahyaa General Hospital
and Al-Sadr Teaching Hospital during the period from January to March 2015. Data
were collected through an interview questionnaire and laboratory investigations.
Results: The prevalence of hypertension (BP ≥140/90 mmHg or on medication for
high blood pressure) was 73% (50.8% old hypertensives and 22.2% newly
diagnosed). Only 20.2% of the old hypertensive patients were with controlled blood
pressure. Age, body mass index, and poor glycemic control were found to be
significantly associated with hypertension.
Conclusion: Hypertension is a common co-morbid disease among diabetic patients in
Basrah, and a large proportion of those with hypertension had uncontrolled blood
pressure.

Objective: The aim of this study is to evaluate the effects of proinflammatory cytokines and
some hormones, in patients with endometriosis, on the serum levels of bone formation and
bone resorption markers.
Subjects and methods: Eightyfemale patients with endometriosis at their reproductive age
subjected to standard criteria were participated in this study. Eighty apparently healthy women
were selected to be a normal group for comparison. In addition, assessing the serum levels of
tumor necrosis factor alpha [TNF-α+, interleukin 1[IL-1], interleukin 6 [IL-6],
CarboxyterminalTelopeptides of type I Collagen [CTX1], CarboxyterminalPropeptide of type I
Procollagen [PICP], Estradiol [E2], Follicle-Stimulating Hormone [FSH], Thyroid-Stimulating
Hormone [TSH], and Parathyroid Hormone [PTH] by EILISA and enzymatic Kits.
Results: The results show that the levels of tumor necrosis factor alpha [TNF-α+, interleukin
1[IL-1] , interleukin 6[IL-6], C terminal Telopeptides of type I Collagen[CTX1]and C terminal
propeptide of type I procollagen[PICP], follicle-stimulating hormone [FSH], thyroid-stimulating
hormone [TSH] and parathyroid hormone [PTH] weresignificantly changed in serum of patients
with endometriosisas compared with control healthy group. Whereas, the change of serum
estradiol [E2] level was non-significant as compared with control group.
Conclusions: The inflammatory activity of tumor necrosis factor alpha [TNF-α+, interleukin 1*IL
1] and interleukin 6 [IL-6] was important in the development of osteoporosis in patients with
endometriosisby its effect on bone formation and resorption markers.The role of some
hormones, follicle-stimulating hormone [FSH], thyroid-stimulating hormone [TSH] and
parathyroid hormone [PTH], in the development of osteoporosis in patients with endometriosis
was also assessed.

Of a total of 3325 patients who underwent lower gastrointestinal endoscopy during
2008-2014, 170 (5.1%) patients had a diagnosis of ulcerative colitis. Of those patients
13 (7.6%) were already diagnosed as ulcerative colitis and attending the
gastrointestinal unit for follow up while 157 (92.4%) are newly diagnosed. Among
the newly diagnosed patients 94 (59.9%) are males and 63 (40.1%) are females, with
age onset range from 5-75 years and average age 39.5 years. Hematochasia is the
most frequent clinical symptom (39.5%) followed by bloody diarrhea (33.1%) while
weight loss is the least frequent (2.5%). Left sided ulcerative colitis is the more
common site of involvement 66 (42%) while proctosigmoiditis is the least common
20 (12.7%). Grade I & II are the most common endoscopic grading 93 (59.3%) while
grade IV 24 (15.9%) is the least common.
Aim: this study is aimed to analyze cases of ulcerative colitis disease in Thi-Qar
patients who had been diagnosed at the gastrointestinal unit in Al Hussain -Teaching
hospital.

Class 1 integrons play a role in the emergence of resistant bacteria by facilitating the
recruitment of gene cassettes encoding antibiotic resistance genes. inhibition zone
diameters were determined in tests with imipenem (IPM) and meropenem (MEM)
discs alone and in combination with 1000 µg of EDTA Combined disk diffusion
method was used for detection of integron CS type metallo-β-lactamase-producing
isolates, they were emplace each of imipenem and meropenem antibiotics with
EDTA on Mueller-Hinton agar, because EDTA working to inhibit of metallo-β
lactamase enzymes and increase the diameter of inhibition zones. The results
revealed that out of 0 ∕ 22 (0 %) isolates produce these enzymes with imipenem and
out of 0 ∕ 22 (0 %) isolates produce these enzymes with meropenem. All the 22
isolates were submitted to molecular detection of Integron CS by using PCR assay.
The results showed that only 1 (4.5%) isolates were carried Integron CS.

This field of study focuses on the multi-para pregnants and their effect on the size of
a New born babies , after the exposure of pregnant to several internal and external
factors affect the size and nature of the child.
Objective: this study was designed to identify risk factors for low birth Weight
Neonate.
Methodology: A descriptive study (cross-sectional design) had been done on
pregnant on Low Birth Weight Neonate, starting from the 17th June2013 to 14th
April 2014. Non –Probability (purposive) sample of (160) pregnant women , the ages
range between (15-45) years . Most of the samples Previously diagnosed for at least
(2)month Low Weight Neonate. They visited the care centers for pregnants women.
The data were collected through the use of semi-constructed questionnaire, which
consists of two parts; (1) Socio demographic data previous history (2) Reproductive
characteristic, Reliability of the questionnaires are determined through a pilot study
and the validity through a panel of (10) experts. The data were described statistically
and analyzed through the use of the descriptive and inferential statistical analysis
procedures.
Results :The findings of the present study indicate that the Low Weight Neonate
affected by the obstetrical history. The maximal effect presented by the premature
baby , and type of delivery. There is no significant association of Reproductive
characteristic with Demographic, age, education level, Occupation and
Consanguinity . But high significant to previous premature baby ,type of delivery and
receiving antenatal care during pregnancy .
Recommends: Regular and proper prenatal care provided in the health centers and
through home visiting. develop a special programs in the radio, television magazines
, newspaper concerning pregnancy and prenatal care specially to school age girls
using interesting teaching aids such as pictures diagrams …etc. taking in
consideration the public's income and level of education.

Investigation the effects of low-level laser (532nm)irradiation and hyperthermia combination
with chemotherapy on white blood cell activity in patient with different type of cancer,
measuring by mean of luminol-dependent chemiluminescence(CL).Diminished function
activity of peripheral blood neutrophils has been found in untreated human patients with
several different types of cancer.As expected, cell viability decreases gradually with time .
About 60 min, cell viability was about 75% in the control group, while in the group heated to
40oC, only 30% of the cells are viable. Approximately 60% of cells died after a 30 min exposure
at 40oC. Exposure for 60-120 min at 40oC causes a similar effect .Laser radiation causes
significant enhancement of spontaneous chemiluminescence response(P<0.05).Un expected
result,the increase in CL functional activity has been found with laser treatment for all times of
irradiation. A maximum enhancement in CL functional activity has been found at about 60 min
of irradiation (P<0.05). A combination of laser and HT has similar behaviorof CL
response(P<0.05).The conclusion drown from this in vitro study demonstrated that diode laser
radiation (at low power levels laser (λ = 532 nm, I = 150 mW/cm2 ) combination with
hyperthermia causes enhancement effects in phagocytosis activity of white blood cell in cancer
patient.

Objective: To assess the incidence, different clinical pictures & treatment of a
patient with inhaled foreign body and to compare our study made at Al – Hussein
Teaching Hospital with those done in other centers and hospitals in Iraq.
Patients: This is a prospective study of 100 patients with history of foreign body
inhalation who attended the casualty of Al-Hussein Teaching Hospital in Nassiriyah
from the first of August 2014 to the first of April 2015. Most of them had been dealt
with by rigid bronchoscopy.
Methods: The case sheets of relevant patients who had been admitted to Al –
Hussein Teaching with history of inhaled foreign body were reviewed to collect
information like sex, age, types of inhaled foreign bodies, clinical features of
patients, operative notes, etc…..
Results: All patients were admitted into Al-Hussein Teaching Hospital and the
procedure of rigid bronchoscopy was prepared for all of them regardless the age and
sex. Fortunately, 3% of patients could be discharged before carrying out the rigid
bronchoscopy due to spontaneous expectoration of foreign body during their
admission while the rest had undergone the procedure without complications and
unfortunately 2% of our patients needed thoracotomy. The procedure of rigid
bronchoscopy of a significant percentage of patients had been postponed after
admission into the hospital for several days because of severe chest infection
( pneumonia ) and the patient had been put on heavy injectable antibiotics &
steroids until improvement of the clinical picture of the patient and resolving of the
lung consolidation before carrying out the rigid bronchoscopy under general
anesthesia. This is true for those with history of inhaled foreign body several days,
weeks or months ago but not for those with recent history of inhaled foreign body.
Patients presented with different clinical features. Various radiological findings had
been noticed and many kinds of foreign bodies could be removed. No mortality was
recorded.
Conclusions: Every effort should be made to remove the inhaled foreign body to
relieve dyspnea, prevent complications and probably save life.

The aim of the present study was designed to determine the relationship between
the infection with T. vaginalis and use of contraceptive among women whom
suffering from abnormal vaginal discharge in Nassirriyah city \ Thiqar Province using
TVK3/7 gene as target by PCR technique. all women entered the Maternity and
pediatrics hospital , private clinics and laboratories.
The results are explain that the infection with T. vaginalis are decrease during the
use of contraceptive since there are no case of infection with T. vaginalis among
women whom used injection , pills and tubal ligation except there is three or
3(0.67) cases of infection is recorded among women who use of IUCD compared with
11 (3.1) total infection among women whom are not use the contraceptive.

The Antimicrobial properties of the ethanolic leaf extract of the Suaeda aegyptiaca plan, on four
bacterial isolates (Stapshylococcus aureus, S.epidermidis, P.aeruginosa,and Escherichia coli),were
investigated . The antimicrobial activity of the plant extract was determined by the Well diffusion
method. The ethanolic leaf extract of all the plants inhibited the test organisms. The spectrum of
antimicrobial activity was recorded against S. aureus(26.66-14.66 mm),S.epidermidis(22-15.22
mm), P. aeruginosa(20.33-13.33 mm), and E.coli (21.66-18.55 mm) at (10-2.5%) con.
The studying extract exhibited antimicrobial properties compared favorably with some standard
antibiotics .The maximum zone of inhibition of antibiotics was measured against S.aureuswas (E)
(16mm), on the other hand, (ST and AM) had no effect on its. S.epidermidis was highly sensitive to
(NOR) was 38mm and resistant to (AM and L). E.coli and P.aeruginosa was highly sensitive to
(AM),while it is resistant to (CAZ,PY and CXM).As well as AMC and CD had no effect on P.aerug-
inosa.Compare with The screening results of the medicinal plant extract in the present study
confirmed a source of antimicrobial agents by the highest sensitivity was recorded.

Endometriosis is a hormonal and immune system disease in which cells similar to that which
line the uterus (endometrium) grow outside the uterine cavity, most commonly on
the membrane which lines the abdominal cavity, the peritoneum. The uterine cavity is lined
with endometrial cells, which are under the influence of female hormones. Endometrial cells in
areas outside the uterus are also influenced by hormonal changes and respond in a way that is
similar to the cells found inside the uterus. Common symptoms of endometriosis are pain and
infertility. The pain often is worse with the menstrual cycle and is the most common cause of
secondary dysmenorrhea.Endometriosis is typically diagnosed during the reproductive years,
but has been diagnosed in girls as young as 8 and has been found to continue past menopause,
Symptoms may
[1]
10% of women
.
[1]
it has been estimated that endometriosis occurs in roughly 4
depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in
various manifestations. There is an established association betweene.endometriosis and
There is no cure
Endometriosis has a significant social and psychological impact.
[2]
infertility.
for endometriosis, but it can be treated in a variety of ways, including pain medication,
e on 76 infertile females more than 5
[3]
This study was don
hormonal treatments, and surgery.
years , general seminal analysis of those females partners were normal ( active form of
sperms are more than 50% with good number of sperms , high percentage of normal
morphology of sperms in general seminal analysis) examination of those females genital tracts
and sex hormonal assay with prolactin hormone all normal except the endometriosis of the
wall of uterus with the parietal peritoneum and posterior layer of anterior abdominal wall one
year(feberury2011-feberury2012) spend for collection of data and other 2 years( feberary2012
feberury 2014) for fallow up the patients for pregnancy . age of patients range between 28—38
years , 13.2% of patients had previous caesarian section.We get from this study 63.1% were get
pregnant after the surgical treatments of endometriosis within 2 years post operatively. 37.5%
were pregnant at first 6 months post operative , 29.2% at 2nd 6 months after operation and
33.3 at the 2nd year after operation .

Background:Wounds and their management are fundamental to the
practice of surgery. Surgical wound dehiscence after laparotomy remains a serious
complication. To evaluate the effect of prophylactic retention sutures in patients
with a high risk for wound dehiscence who underwent midline laparotomy.
Patients and methods :One hundred fifty(150) cases were randomized to form two
groups with 75 patients each: a prophylactic group by using retention sutures and
an non prophylactic group. A central randomization for both hospitals was
performed. Two patients in the non prophylactic group and three patients in the
prophylactic group
In the non prophylactic(control) group Standard midline incision and continuous
mass closure technique was used in each case using a running looped 1/0 nylon
string located 1 cm from the edge of the linea alba. In the prophylactic group, the
fascia was sutured using the same technique as the non prophylactic group;
however, retention sutures were added using a 1/0 nylon string every 10 cm and
contained 5 cm of the skin, subcutaneous tissue, rectus muscle, and abdominal
fascia (except peritoneum) on each side. All fascia closures were performed by tow
attending surgeons who adhered strictly to the protocol. Occurrence of abdominal
dehiscence was assessed daily by precise examination of the wound.
Results: The incidence of abdominal wound dehiscence was 3 patients (4%) in the
prophylactic group and 10 patients (13.3%) in the control (non prophylactic )group (P
= 0.007 ) therefore it is significant
Conclusion: Our conclusion that prophylactic retention sutures can decrease the
incidence of abdominal wound dehiscence but although there is decrease incidence
of postoperative evisceration ,wound infection and postoperative pain , there was
no significant difference.