Thi-Qar Medical Journal

Background Type 2 diabetes mellitus (T2DM) is associated with an increased risk of
cardiovascular and cerebrovascular diseases with high mortality and disability. Cerebral
vasomotor reactivity (VMR), one of the most accurate markers of cerebral hemodynamics,
has been shown to be impaired in subjects with carotid artery steno-occlusive disease and
associated with an increased risk of ischemic events. Transcranial Doppler ultrasonography
)TCD( study have been used to investigate cerebral vasoreactivity to identify patients with
increased risk and to better plan the treatment.
Objective: The aim of study was to assess cerebral vasoreactivity among type2 diabetes
mellitus patients by using transcranial Doppler ultrasonography.
Patients and method: sixty five persons (45 type 2 diabetic patients and 20 normal control)
(32 male,33 female) with mean age (46.95 ±7.459) enrolled in this study. The study groups
are collected randomly from Al Najaf center for Diabetic and endocrine in Al Sader teaching
hospital during the time between January 2016 to June 2016. TCD examination was
performed in Middle Euphrates Neuroscience Center for all stuied group to assess cerebral
vasoreactivity in middle cerebral artery by breath holing test,hyperventilation test (HV),
Transient hyperemic test (THRR). (Statistical Package of Social Sciences) SPSS version 23
was used for the statistical analysis.
Results : There was highly significant change of breath holding index BHI{ between control
group and diabetic group} (p.value<0.05) and significant change of HV between control
group and diabetic group . Also statistical significant change in THRR in relation to glycemic
control(p.value< 0.05).
Conclusion : There was significant changes in TCD indices that assessed cerebral
vasoreactivity in breath holding index, ,hyperventilation in type2 diabetic patients compared
with control subjects.

Background: The prevalence of overweight and obesity is increasing in both developed and
developing countries. Obesity is a major risk factors for many chronic diseases including
diabetes, hypertension and ischemic heart disease, so it is considering a major Public health
problem.
Objectives: to study the prevalence of obesity and it is risk factors among Thi-Qar university
students.
Subjects and Method: A cross sectional study had been extended from 1st of April 2016
to10th of June 2016, a total of 841 students (358 of male and 456 of female) between 18
years and 36 years of age (mean 21.7 ± 2.3years) were selected randomly from 24 colleges
of both Thi-Qar university and Mazzia college. Each participants subjected to a
questionnaire that include: personal socio-demography, time of sleep per night, types of
activity during leisure times, height, weight and waist circumference were measured and
body mass index was calculated and used to asses’ weight status. The data was analyzed by
using SPSS. p value less than 0.05 was considered as statistically significant.
Result: The mean BMI was 24.17 ± 4.0; more than half (59.2%) of students were of normal
weight ( 63.8% of male students and 55.2% of female students ) ; whereas the prevalence of
overweight and that of obesity among them was 28.3% and 8.1% respectively. The
prevalence of obesity was nearly similar between male and female students, while the
prevalence of overweight was more common among females students as compared to males
(32% of females vs. 23.1% of males).The prevalence of underweight was more common
among male than female students (5.1 % of male vs. 3.7 % of female ) . Depending on their
waist circumferences 3% of male and 18 % of female students where at a higher risk of
developing abdominal obesity co morbidities. There was significant higher prevalence of
obesity and mean waist circumference with in students of more than 26 years old age and of
less than 6 household family number (p < .05 for both variables). A relatively high
proportion (42.7 % for male and 35.8 % for female) spend more than two hours on screen
time daily. Females where significantly (p< .05) much less physically active than male.
Conclusion: there was high prevalence of obesity among ThiQar university students and the
study supports the multi factorial etiology of obesity; it demonstrated that age, parent’s
education and household number are risk factors. The study also shows high prevalence of
sedentary behaviors, physical inactivity among Thi-Qar university students.
Recommendation: the study results mandate the need for a Public Health strategies to
prevent overweight and obesity and adopt a healthy dietary habit and life style.

Background: The use of contraceptives was recorded to be high in Iraq, as family
planning became important to deal with the highly increasing population. No data is
available about the relation between the use of contraceptives and mental health.
Aims: to report on depression among Iraqi women using contraceptives
Subjects and methods: A total of 139 married women using contraceptives were
included in the study for the period 2nd January to 30th November, 2014. The sample
was recruited from the gynecology outpatient clinic of Baghdad Teaching Hospital.
Socio-demographic and clinical data were obtained and Beck Depression Inventory II
was used to rate depression.
Results: Sixty three (63.3%) of women have depressive syndrome. There was no
significant association between type of contraception and depression
Conclusion: Depression is common among women using contraception.

Summary
Background, Diabetes mellitus is one of the most common metabolic diseases in the
world and the number of its patients still growing and according to the International
Diabetes Federation reach 552 in 2030. Hypoglycemia is dangerous adverse effect of
insulin therapy and remains an unsolved problem; During hypoglycemia lack of glucose
supply to neurons can lead to confusion, seizures, brain damage which is sometimes
irreversible and can even cause death. Aim ,The study designed to test the effect of acute
insulin induced hypoglycemia on: 1)the brain oxidative status as measured by
Malondialdehyde (MDA). 2)brain neurotransmitters; dopamine, ɣ-Amino butyric acid
(GABA)and noradrenaline. And Possible protective effect of gabapentin and olanzapine
against hypoglycemia. Method and Materials, 32 male rabbits, randomly divided into
four groups, group A (control group) treated with (2.5ml/kg) distilled water orally and
(0.1 ml/kg) distilled water subcutaneously. Group B (Hypoglycemic group) treated with
(2.5ml/kg) distilled water orally and (1 IU/kg) insulin subcutaneously. Group C
(hypoglycemic group + gabapentin) given (25 mg/kg) gabapentin orally and (1 IU/kg)
insulin subcutaneously. Group D (hypoglycemic group + olanzapine) treated
with(2mg/kg) olanzapine orally and (1 IU /kg) insulin subcutaneously. Blood samples
used to determine glucose level and brain tissue used to estimation neurotransmitters.
Statistics, Results are presented as the mean ± Sd. Statistical significance was set at P <
0.05 and determined by the (SPSS) version 22. Data were analyzed by one-way ANOVA
and unpaired t-test. Results, Insulin treated group show significantly increased of MDA
and noradrenaline in comparison to control group. In (insulin + gabapentin) treated group
show significant decreased of dopamine and no significant changes of GABA and
noradrenaline in comparison to control group. While (insulin + olanzapine) result was
significantly increased of MDA and decreased of both dopamine and GABA in
comparison to control group. On other side the use of gabapentin with insulin lead
significant decreased of MDA and dopamine, significantly decreased of noradrenalin and
Significant decreased of glucose levels at day one 10 AM, in comparison to use insulin
only. While addition olanzapine to insulin show the following result no significantly
increased of MDA, Significant decrease of dopamine and GABA and No significant
decreased of noradrenaline in comparison to use insulin only. Conclusion, Insulin
hypoglycemia lead to oxidative stress and brain neurotransmitters disturbance which are
partly reversed by gabapentin and olanzapine, on the other hand both drugs tend to
exacerbate insulin induced hypoglycemia. Caution should be excreted when giving any of
the two drugs in such situation.

Background: Several authors suggested that weekend mortality rate is higher than
that of other days of the week; on the contrary many authors refuse this suggestion
and stated that there is no significant impact of the weekend on mortality rate.
Objective: To study the impact of weekend on mortality rate.
Patients, Materials and Methods: The present study was carried out in Al-Karama
and AL-Zahraa hospitals in Kut city by reviewing records regarding mortality
throughout the period extending from January 2015 through December 2015. Data
were classified into the following categories: number of patients admitted on weekend
and died in the hospital at any day versus the number of patients admitted on
weekdays and died at any day ; number patients died in the hospital at weekend
versus number of patients died at weekdays.
Results: Significant difference in percentage of death was found on week end in
comparison to weekdays (P=0.007), whereas there was no significant association
between admission on weekend and percentage of death (P=0.111).
Conclusion: Weekend witnessed significantly higher percentage of death in
comparison to weekdays which is probably due to less staffing and equipment during
weekends.

Background: Hypertension is the prominent cause of early death in the world and the
number of population with hypertension is developing. It is a preventable risk factor for
stroke, myocardial infarction, heart failure, peripheral vascular disease, aortic dissection,
atrial fibrillation, and end-stage kidney disease.
Aim of Study: General Objective: To assess the extent of life style modifications among
hypertensive patients.
Specific Objectives:
1. To measure the awareness of hypertensive patients about life style modifications.
2. To investigate the status of adherence to life style modifications among hypertensive
patients.
Methodology: The study was an analytical cross sectional study for 576 hypertensive
patients who had intended Al-Hussain teaching hospital in Nasiriya city during the period
from the first of January 2016 to the end of September 2016.
The study population included all patients aged 25 years and above of both sexes with
previous diagnosis of hypertension made by medical staff. While the exclusion criteria
included those who were not aware that they have hypertension, all pregnant women with
gestational hypertension were also excluded.
Conclusion: This study reveals that there is a poor level of awareness of lifestyle
modification which is needed in the management of hypertension among a representative
sample of adult hypertensive patients how attended Al-Hussain teaching hospital.

The bacterial colonization in gallbladder represent important factor in initiation of
gallstone and chronic cholecystitis. The aim of the study was to detect the facultative
anaerobic bacterial isolates and determination of the most efficient antibiotics in
treatment of gallbladder infections. Bile specimens were collected from 62 patients
who have suffered from gallstone cultivated on bacteriological media, the diagnosis of
isolates
and
antibiotic
susceptibility test for the following antibiotics
(CIP,NOR,AK,CN,CTX,CRO,CL,AMC,SXT,AZM and TET) was done by using
standard bacteriological techniques. According to results (14.51%) of the examined
bile specimens were positive cultures with predominance of E. coli which represent
(54.55%) of isolates followed by Enterobacter spp. (18.18%) with high significant
differences (P< 0.001), The flouroquinolones (CIP & NOR) were most effective
antibiotics followed by aminoglycosides (AK,CN) and CTX under (P< 0.05).
Furthermore, the isolates showed high and complete resistance to other antibiotics. In
brief, colonization of bacteria may associated with the formation of gallstone where
the E. coli is the most frequent bacterial isolates and the flouroquinolones (CIP &
NOR) appear to be highly effective against isolated bacteria and may play a role in
treatment of infections.

Introduction: Adult with congenital heart diseases (ACHD) are an important emerging group.
The diagnosis and successful management of congenital heart disease represents one of the
greatest triumphs of cardiovascular medicine and surgery in the 20th century. As a consequence,
the number of adults with congenital heart disease both with repaired and unrepaired lesions has
grown rapidly.
Patients and Methods: This is a descriptive cross sectional study that conducted in Ibn Al-Bitar
Center for Cardiac Surgery during the period from January 2011to December 2012 Baghdad-
Iraq. In this study all adults’ patients with CHD referred to Ibn Al-Bitar Center for Cardiac
Surgery were recorded and evaluated to verify the pattern of ACHD in our center.
Results: A total of 789 patients, female to male ratio was 1.7:1, Acyanotic CHD constitute
92.9%, and whereas the cyanotic lesions form only 7.1% .The mean age of patients was
29±7.300 SD years. The most common defect was ASD followed in order of frequency by VSD,
PS, TOF, PDA, AS and COA. Trans catheter intervention was the treatments of choice for many
types of ACHD, but still surgery play an important role in managements of other defects.
Conclusions: Acyanotic ACHD are more common than the cyanotic one, more female
predominance, Percutaneous intervention was became widely used as the first line of
management of majority of ACHD with high successful rates, while surgical correction still the
treatment of choice for certain types of ACHD .

In present study, mice burn model were used to study the complications of
bacterial infected burn cases. Eighteen male albino mice were used as a burn model
which divided into two mice groups burned by boiled water (scald method), then
injected by physiological normal saline (negative control), two mice were infected by
Pseudomonas aeruginosa 0.2 x 108 Colony Form Unit (CFU) without burn, on other
hand two mice were infected by Staphylococcus aureus (0.2 x 108 CFU) without burn,
these two groups considered as a positive control. Other mice divided into two
groups, each one contains six mice burned and infected by nosocomial bacterial burn
isolates (0.2 x 108 CFU), all groups were followed up for 7 days then killed and
histopathological changes of some internal organs were examined, livers and lungs of
examined samples showed significant pathological changes in coparision to the
negative control, suggesting that these samples suffered from variety degree of
hepatitis and pneumonia. These results were due to the complications of bacteremia
and septicemia of burned model.

Background: Telogen Effluvium (TE) among women is a challenging common
problem for Dermatologists and data on its prevalence among Iraqi women is limited
hair loss is a distressing problem for women because femininity and attractiveness is
linked to women's hair.
Aim of study: To find out the main risk factors of Telogen Effluvium among women
in Thi-Qar Province ( Iraq ). Some of these risk factors are investigated before in Iraq
but not in Thi-Qar province such as TSH while others such as Vitamin D are barely
investigated in Iraq.
Patients and methods: A descriptive cross sectional study carried out in Dermatology
Outpatient Clinic of Al-Hussein Teaching Hospital, Nassiriah City ( Thi-Qar Province
Center), Iraq through the period from 1st of March, 2014 to the end of June, 2015 on
random sample of 100 women with Telogen Effluvium and convenient sample of 100
healthy controls. Thyroid stimulating hormone, serum Ferritin and Vitamin D3 levels
of both groups were measured.
Results: There was a significant association between positive family history of hair
loss and women with Telogen Effluvium (p<0.001). No significant difference in
thyroid stimulating hormone level was observed between cases and controls (p=0.6).
There was a significantly lower serum Ferritin and Vitamin D3 levels among women
with Telogen Effluvium (p<0.05).
Conclusion: Low serum Ferritin and Vitamin D3 levels among women might play a
major role in etiology of Telogen Effluvium.

Background :
The aim of this study is to research the in vitro effect of the He-Ne laser radiation and
study the effect of environmental temperature on Erythrocyte Sedimentation Rate (ESR)
in blood samples from healthy .
Objective : To show the effect of He-Ne laser and effect of environmental temperature
on Erythrocyte Sedimentation Rate (ESR)
Subject & Methods : He-Ne laser wave length of 632.8ηm was used for irradiation with
0.5mm diameter beam spot on blood samples, with power density 1mw/cm2 , The
irradiation times were (1hr ) , The samples of blood were obtained 30 contributors and
each sample was separated into three samples for irradiation and control .
Results :
The results showed that there were significant differences in the values of sedimentation
rates for both class (25 -45 ) 0c degree heat compared with the values of sedimentation
25 0c degree heat temperature for irradiation and control .
It shows the effect of temperature factor on the red blood cells sedimentation rate in
blood samples from healthy people and see the effect of the degree of laboratory heat
due to lack of efficient heating and cooling devices in the summer and winter on the
sedimentation rates of values to be taken into consideration with the results .
Conclusion :The change of temperature (high and low) has a great effect on the
deposition and precipitation of red blood cells in health people and thus must be taken
into consideration and this effect is also observed with the use of He - Ne laser at a
temperature of 25 ° C.

The aim of the following study was to estimate the levels of trace elements in
hydatid cyst fluid and evaluation the role of this elements on parasite life . trace
elements in the fluid of hydatid cyst were detected by atomic absorption spectroscopy
which found high ratio of Ca, K, Fe, Mg, Mn, Na, Cu, and Zn while P, Cr, Co, Cd,
Pb, and Ni were low and include ( 8.71, 9.55 , 15.36, 5.91, 9.2 , and 11.3 \ µg )
respectively .