Thi-Qar Medical Journal

BACKGROUND: A Retrospective
study of 31 patients who diagnosed as a case
of primary pulmonary hypertension (PPH) in
Ibn-Albitar hospital for cardiac surgery, from
July 1999 to April 2007, to study the clinical
pattern of PPH in children and adult, who
diagnosed as acase of PPH clinically and
echocardiographically and confirmed by
diagnostic cardiac catheterization. Patient
and Method: This study excluded cases of
secondary
PAH and those without
catheterization. Two cases excluded from
PPH cases (one patent ductus arteriosus
eisenminger`s syndrome and other is large
sinus venosus atrial septal defect). These data
were collected from medical files or
catheterization files, including:(age, gender,
duration of symptoms before reaching
diagnosis of PPH, number of hospital
admissions, signs, and symptoms of PPH,
echocardiographic
findings),
considering
pediatric age group ≤ 18year and adult
>18year, and the catheterization data were:
way of reaching final diagnosis in
catheterization, severity of PAH and mean of
MRAP, MPAP) also morbidity and mortality.
Conclusions :the pediatric cases tend to
present earlier than adult cases, Females cases
more than males cases. The duration of
symptoms before catheterization was short,
and it was shorter in adult cases. The most
common symptoms in pediatrics are(cyanosis,
fatigability, and extensional dyspnea), while
in adult (exertional dyspnea, chest pain and
fatigability).The
most common signs in
pediatrics are (normal physical examination,
loud second heart sound and murmur)while in
adult (murmur, dyspnea, loud second heart
sound). The catheterization approach to reach
definite diagnosis in most pediatrics (by
normal pulmonary capillary wedge pressure)
while in adult (by exclusion secondary
causes). Recommendations: atrial septal
defect-sinus venosus should be considered in
exclusion list of secondary PAH, familial
cases need genetic analysis, loud second heart
sound is important clue for PPH, especially if
associated
with
dyspnea on exertion.
Pregnancy still wanted by certain families,
and counseling for patients and their families
regarding risk of pregnancy is essential.

Background: In order to implement a better
and high standard quality of reproductive
health care services, customers should be
ensured to have the appropriate needed service.
Moreover, granting a better quality service
encourage more beneficiaries in need, improve
the coverage of reproductive health and family
planning services and reduce maternal & child
morbidity and mortality due to reproductive
health related problems.
Objectives: The study aims to look at the
perception of health providers regarding the
needs of the women age(15-49) years living in
Basra in the area of reproductive health, in
addition to identifying factors influencing the
performance of reproductive health and family
planning service providers.
Subjects and method: A face to face interview
questionnaire was used with 159 health care
providers from different levels of public health
care facilities in Basra.

Genu varum (bow leg) represents one
of the most common lower limb deformities
in children. Its aetiology is divided into two
main categories, physiologic and pathologic.
It poses a source of concern for the parents.
In physiologic genu varum, the condition is
self-limiting and usually it needs just clinical
follow up. In pathologic cases it is liable for
progression with time predisposing for
mechanical lower limb problems as well as
joint complications. In the physiologic
variety, it is important to establish the
diagnosis so as to avoid unnecessary
treatment.

Background: Acne is a common skin
disorder that affects both adolescent and
adult. However few studies on this condition
have been done in Iraq.
Objectives: The purpose of this study to identify
new precipitators and aggravators of acne.
Methods: We collected data using structured,
self-administered questionnaire, among patients
having acne vulgaris who were attending al
Hussain teaching Hospital, Dermatology and
Verenology outpatient Clinic, in Thi-Qar, Iraq. A
cross-sectional study was conducted.
Results: A total of 105 patients were included
in this study (70female 35 male) the mean of
*College of medicine /Thi-qar University
**Bent Al-Huda Teaching hospital Thi-qar Iraq
age ±SD 19.78year ±5.155. , the mean of
BMI± SD 24.97 ±5.28 (n=101). Where the
history of oral herbal remedies or oral steroid
as an appetite stimulant present in 22%, the
history of applying topical cosmetic in 47%
also 66.6% of patients consider the exposure
to sun light exacerbate the acne vulgaris, the
role of menses in female (n=70) are 44.2% in
addition to 38% of sample consider the hair
removal process by using thread and
bleaching as aggravating factors.
Conclusions: Hair removal process, use of
topical cosmetic products and oral herbal
remedies or oral steroid intake has been
positively related to acne vulgaris.

Objective: To Assessment Quality of Life for Patient with Thalassemia at Thalassemia Center in Thi
Qar Governorate, and to identify the association between nurses' socio-demographic characteristics of
age, gender, marital status, occupation and blood group and their effect to quality of life for patient
with thalassemia.
Methodology: A purposive "non-probability" sample of (100) patient who were selected from
thalassemia Center in Thi-qar governorate for the period from October 4th 2014 to April 1st of 2015.

The aim of this study was to find the
incidence of urogenital mycoplasma such as
Mycoplasma
hominis
and
Ureaplasma
urealyticum among women attending infertility
clinic.
The total number of (n = 300)
endocervical swab samples taken from women
attended to Maternity Hospital outpatient clinic
in Thi-Qar. One hundred fifty swabs was taken
from women has a period of infertility of at
least one year and both partners had ready the
basic infertility investigations (group I). One
hundred fifty swabs were taken from fertile
women who attended the family planning clinic
Thi-Qar
(group II). It was found that the
incidence of Ureaplasma urealyticum was
significantly higher in the infertile (22%) than
in the fertile group (4.7 %) (Z = 5.6, P < 0.01).
The incidence of Mycoplasma hominis was not
significantly different between the infertile
(26.6 %) and the fertile (21.3 %) groups had
been studied (Z = 1.71, P < 0.05). During the
period of the present study, the infertile women
with
positive
culture
for
Ureaplasma
urealyticum (33 women) and their husbands
were treated with doxycycline ±azithromycin
oral capsules that successfully eradicated the
Ureaplsma urealyticum from the endocervix of
the infertile women. The pregnancy rate after
eradication of Ureaplasma urealyticum was
(28.5 %) in couples with unexplained infertility
which was higher than in couples with
explained infertility (6.6 %).

Burn infection is a main cause of
morbidity and mortality. Burn patients are more
susceptible to get infections in comparison with
other patients. This study has been conducted to
determine bacterial pathogens frequently
causing burn infections and their antimicrobial
resistance patterns.
This study was carried out on thirty
patients admitted to the burn unit at Al-Hussain
Teaching Hospital/Thi-Qar Province during a
five-month period from August 2015 to
December 2015. A swab has been taken from
each
patient.
Antibiotic
sensitivity
performed by the disc diffusion method. Tested
antibiotics used in this study were ampicillin,
augmentin, ciprofloxacin, cefepime, ceftazidime,
ceftriaxone, gentamicin, imipenem, tobramycin,
vancomycin, levofloxacin, piperacillin, ticarcillin
clavulanic
acid,
netlimicin,
amikacin,
chloramphenicol, ticarcillin, , tetracycline, Co
Trimethaxazole and rifampicin.
Thirty four bacterial isolates were obtained
from thirty swabs. We found that the most
predominant bacterial isolate was Pseudomonasspp.
(49%), followed by Klebsiella spp. (21%),
Staphylococcusspp. (12%), Escherichia coli
(E.coli) (6%), Proteus spp. (6%), Acinetobacter
spp.
(3%) and Enterococcus spp. (3%).
Polymicrobial infection was obtained in (13.3%)
of patients.
All isolated pathogens were multi-drug
resistant.Acinetobacter spp. and Enterococcus
spp. were the most resistant pathogens (100%),
followed by E. coli (90.47%), Staphylococcusspp.
was
(79.17%) , Klebsiella spp. (68.75%), Proteus
spp.(68.75%) and Pseudomonas spp. (65.88%).
Gram-positive bacteria showed complete
resistance against ampicillin, while Gram
negative bacteria showed high resistance against
augmentin, cefepime, ceftriaxone, tobramycin
,piperacillin, ticarcillin-clavulanic acid, amikacin,
chloramphenicol, and tetracycline.
Non-significant difference was found
among the tested antibiotics concerning resistance
(P
value >0.005). However ciprofloxacin,
gentamicin and imipenem were significantly
effective against most types of pathogens
compared to all tested antibiotics (P value <0.005).
In conclusion Pseudomonas spp. were
the most predominant pathogen. All isolated
pathogens were multi-drug resistance which is
an emerging problem. We need more periodic
studies to evaluate bacterial resistance from time to time to help in treatment policy.

Objective: The aim of this study was to
investigate the relation between number and
size of preovulatory follicles and the outcome of
controlled ovarian hyperstimulation (COH) and
intrauterine insemination (IUI) in cases of
unexplained infertility.
Subjects and methods: This prospective study
included
200
couples
with
unexplained
infertility. They were submitted to COH with
clomiphene citrate and hMG followed by hcg
when at least one growing follicle reaches the
size of >18mm follicular monitoring started on
the 10th day of the cycle until at least one
follicle reaches 18mm or more. We recorded the
highest follicular count of different diameters in
the two ovaries during the days preceding hCG
injection. Growth of more than one follicle with
a diameter of >18mm is considered
multifollicular growth. IUI was performed with
fresh sperm 24 to 36 hours after hCG
administration to a maximum of three cycles.
The primary outcome measure was achieving
pregnancy confirmed by rising hCG levels.
Results: Eighteen couples were excluded from
the study. Clinical pregnancy occurred in 42
cases (23.1%). Significantly higher pregnancy
rates were achieved in younger females (73.8%)
and in those with duration of infertility <5 years
(28.6%).Pregnancy rate increases significantly
with more follicles >12mm or >15mm,but not
with number of follicles >18mm. Pregnancy
rate was significantly higher in cases with
multifollicular growth.
Conclusion: In couples with unexplained
infertility treated with IUI, pregnancy rate was
positively
associated
with
multifollicular
growth and higher number of >12mm or >
15mm

A retrospectives study for selected 96
patients with chronic IHD (chronic stable
angina and old MI) referred to Holter unit in
AL-Hussein teaching hospital between 20th
June 2014 to 20th March 2015 for 24 hour ECG
monitoring for different symptoms and 102
healthy control individuals .

The therapy processes of tumor cells by
using NPs such as metal zinc oxide nanoparticles
(ZnO-NPs) are studied for many cases.NPs are
the multidisciplinary nanostructure molecules
which are being used in the diagnosis and
dealing of the demanding diseases such as
cancer. This study is achieved by theoretical
method is called curve fitting that simulates the
experimental results of the researchers [7,8]. In
this paper, we summarize the effects of ZnO
nanoparticles and we note the intensity variation
with a degree of diffraction and also the variation of
absorbance with wavelength in the boundary
range of time. One notices that the our
consequences for the NPs match with the
experimental results [7,8] and introduced the
polynomial equations for intensity and absorbance.
From these equations, the results can be
expanded to limit variable values to test the
changes of treatment behaviors.

In this search, we described the most
important corrections to standard energy loss
formula of charged particles and discussed this
formalism with a few remarks by the implication of
the inverse – Bloch correction to the stopping
power calculations. The inverse Bloch correction
extends the range of validity of classical Bohr
and quantum Bethe regime.

Enteric fever is characterized by severe
systemic illness. The leading cause of the
syndrome of enteric fever is Salmonella
enterica serotype Typhi (in the past S. Typhi).
Other Salmonella serovars, chiefly S. enterica
serotype paratyphi A, B, or C, can be a source
of comparable syndrome. The aim of this study
is detects the occurrence of enteric fever among
children in Thi-Qar province and detect the zinc
and cooper levels in their serum and their
relative to infection. The total of (327) blood
specimens collected from children suspected
anguish from enteric fever and (35) children as
control group, the identification of the disease
was depending on clinical signs and using
immune chromatography kits. While, the trace
elements levels was detected by commercial
kits. The results shown that the illness was
detected in 50 (15.29%)of children, the number
of infected males was 28 (56.0%). While female
22 (44%) from infected children with no
significant differences under (P<0.05). The zinc
level of infected child was ( 136.2 ± 46.99 std.)
µg/dl in compared with control group (
120.04±21.20) µg/dl .The copper levels was
(117.88±19.12) µg/dl and in control group was
( 111.85±27.09) µg/dl and the results were not
significant under ( P<0.05 ) between infected
and control groups. In brief, the rate of enteric
fever was high among children under this study
and there is no significant differences among
children gender and trace elements levels with
infection under study.

Among the most common diseases that afflict
the human urinary tract is a bacterial infections
(UTIs) is one more common of these injuries
involve the lower urinary tract, the bladder and
urethra , UTIs are much more common in
elderly than other individuals for a different
reasons,
and
frequently occur both in
community and hospital environments .The
study was aimed at determining the causal
microbial agents of urinary tract infection UTI
infections and the susceptibility of isolates to
propolis as a natural antimicrobial substance
compared with the antibiotcics used . A total of
25 urine sample was obtained from patients (10
male and 15 female ) who were diagnosed with
UTI attending AL- Hussein Teaching Hospital
,Thi-Qar city, Samples were collected between
June and July 2015, cultured and the isolates
were characterized by standard microbiological
procedures. Of the 25 samples,10 male had
positive cultures with E.coli having the highest
prevalence followed by 3 Klebsiella species
and 2 isolates were identified as Staphylococci
species and 15 female positive results with 7
E.coli
followed
by Klebsiella and
Staphylococci species same, and evaluating of
the inhibitory effect of crud propolis against
bacterial isolates. Four graduated concentrations
were prepared propolis 12.5, 25, 50, and 100
mg/ml and its activity was checked up by agar
well diffusion method. The concentration of
propolis exhibit proportionality with zone of
inhibition of bacterial isolates. The propolis at
concentration 50and 100 mg/ml has significant
activity in comparison with antibacterial used in
this study at (P<0.001) for each ,Ceftriaxone 30
µg, Amikacin 30 µg and Gentamycin 10 µg
respectively which were exhibited best activity
from each other antibacterial which have been
used.

Iatrogenic injury of the recurrent
laryngeal nerve (RLN) which frequently leads
to vocal cord paresis or paralysis is one of the
main problems in thyroid surgery. The
incidence of recurrent laryngeal nerve palsy
varies between
1.5-14%. A total of 100 patients
were included in this retrospective study.

Background: Nutritional assessment is the process used to evaluate nutritional status, identify
disorders of nutrition, and determine which individuals need nutritional instruction and/or nutritional
support.
Objective: The aim of this study was directed to estimate the prevalence of malnutrition in primary
school children in Basrah city.
Method: A cross sectional study involving 240 children (107 males and 133 females), drawn from four
primary public school in different area of Basrah city. The data were collected from 26th. of March to
16th. of April 2006.
Nutritional status was determined by international cut off points.
Results: Out of the 240 children, 83 (34.6%) were under weight, 13(5.4%) were overweight. Majority
of the children were within normal height 205(85.4%), 22(9.2%) were stunted. Ninety three (38.8%)
were under weight with a BMI less than 5th percentile and the percentage of underweight was higher
among boys than girls ( 43.0% & 35.3% respectively ).
Only 17 (7.1%) of the study children were overweight with a BMI between 85th percentile to less than
95th percentile.
Conclusion: The results of this study showed that the majority of children were within normal weight,
height and BMI for age and sex, but malnutrition is fairly common

Polyhydramnios is an important obstetric
complication, though an uncommon problem,
but very distressing for patients.
Objective:
This study was carried out to
determine its frequency, causes and fetal
outcome.

Background: Foreign body (FB) aspiration
is a worldwide health problem which can
result in a life threatening complications. It
most commonly occurs among children
younger than 4 years of age, yet inhalation
of sharp foreign bodies are seen more
commonly in adults.
Headscarf pin inhalation is a common and
unique form of foreign body inhalation
among young Moslem women wearing a
hijab.
Standard
flexible
bronchoscopy
(FOB) is used increasingly in the treatment
of tracheobronchial foreign body inhalation
in adults and older children, especially in the
removal of inhaled foreign bodies which
have entered into the peripheral bronchi.
Objectives: The aim of this study is to
investigate the success rate of fiberoptic
bronchoscopy (FOB) in endobronchial
headscarf pin removal, how to minimize
complications, and recommend techniques
to facilitate the application.
Patients and methods: Patients with the
diagnosis of headscarf pin inhalation
admitted to Al-Kadhimyia teaching hospital,
department of cardiothoracic and vascular
surgery from January 2013 to September
2014 were included in the study. Standard
FOB procedure using an oral approach in
recumbent position under local anesthesia
and conscious sedation was performed as the
primary tool for retrieval, the process was
not repeated when the foreign body could
not be removed. In these cases, the foreign
body was removed by rigid bronchoscopy
under general anesthesia.