Thi-Qar Medical Journal

Background: acute childhood and adolescent poisoning remain one of the important emergencies
causing a significant burden to the populations with important morbidity and mortality rates.
Objectives: This study aimed to determine the epidemiological features of poisoning for the patients
less than 19 years old in Al-Nasiriyah governorate, and to eliminate the main types, clinical
presentations, management, outcome, and seasonal variation of poisoning. Epidemiological studies are
so important to determine the extent of the problem, according to which the preventive strategies are
related.
Methods: A cross sectional retrospective study was conducted to three hundred forty patients recorded
in Al-Nasiriyah poison center from (January 2013 to December 2015), data that collected from the case
sheets and records of phone calls including the name, sex, address, type of poisoning, route of
administration, management and the outcome of the patients (survive or died) are admitted to the SPSS
(statistical package for social science) system and the results was obtained.
Results: two hundred (58.8%) of the exposed patients was male, toddler age group seen in 45% of cases
with predominance of accidental type, while adolescents (>13-18yrs.) are mostly intentional with female
preponderance, urban populations are more prone to poisoning 236 cases (69.4%), accidental exposure
is the commonest (83.2%) oral route is the commonest (99.4%), (62.9%) of the causative agents are
pharmaceutical, and (50.3%) are asymptomatic . most of them treated conservatively (96.5%) with
survival rate of (97.9%), higher mortality seen in those presented after the first 24 hrs. of exposure. One
third of acute poisoning was occurred in summer season. Easy accessibility to the drugs and toxic
substances are the major risk factor.
Conclusion: Although poisoning is a preventable illness but, it is still a significant cause of morbidity
and mortality especially in developing countries. Acute poison has a significant impact on the health
services.

OBJECTIVES: The study designed to investigate the level of prolactin (PRL),
thyroid-stimulating hormones, Malondialdehyde (MDA) and ceruloplasmin (Cp)
levelsof the groups of infertile and fertile females in Nasiriyah province, southern
Iraq.
METHODOLOGY: Blood samples were collected from two groups of females
(females with infertility and fertile women) with a total number of 99 infertile women
and 70 fertile females at Bent Al-Huda maternity and children teaching hospital in
Thi-Qar governorate. Autoanalyzercobas e411 instrument was used to estimate of
prolactin, Thyroid-stimulating hormones and Ceruloplasmin levels in sera of patients
and control group using Elecsys and cobas immunoassay analyzers. The MDA level of
the serum was measured by the modified method of Fong et al. (1973). The
concentration of plasma MDA was computed according to the equation of coefficient
of MDA equal to 1.56 x103mol-1. cm-1.
RESULTS: Prolactin and TSH levels were significantly increased (p< 0.0001) in
infertile females as compared to fertile women. A similar pattern was observed to
concentrations of MDA and Ceruloplasmin were significantly increased (p < 0.0001)
in patients when compared to control group.
CONCLUSION:The results of this study indicate that oxidative stress does occur in
infertile females. Patients with infertility showed are higher significant rise in serum
Prolactin hormone and thyroid-stimulating hormone levels in infertility patient group.
All the patients with a high Prolactin level should have TSH estimation.

Aims: This study aimed to identify level of knowledge, and attitudes concerning
Cholera disease among population of Suq-Al-Sheeuq residents, and to find out
association between an overall assessment concerning knowledge & attitudes in light of
studies related of socio-demographic characteristics variables, as well as some of general
information variables.
Methods: A convenient cross sectional design of sample size (110) persons were
selected from Suq-Al-Sheeuq residents, during the period from 1/10/2015 to
1/11/2015,majority of collected samples were from male, and they are accounted
80(72.7%). The results of the review of the questionnaire by the experts revealed that all
of the experts agreed that (60) items of the questionnaire distributed by different main
domains, such that knowledge, and attitudes contents (51), and (9) items respectively,
which were clear and adequate for the measurement of this study, pilot study of (10)
persons proved high levels of reliability of inter and intra examiners, as well as internal
consistency shows that designed questionnaire were valid to study the phenomenon on
the same population at any time in the future.
Results: This research shows moderate of knowledge concerning cholera disease are
presented in the studied sample's persons, as well as results shows that most items of
attitudes are reported good assessments as a result of applying suggested questionnaire.
In addition to that weak relationships with no significant at P>0.05 between studying
"knowledge, and attitude" are accounted rather than differences among their socio
characteristics variables, and weak relationships with no significant at P>0.05, except
distribution of source of water.
Conclusions: Among the main conclusions, the studied responding concerning
knowledge, and attitudes regarding to general information variables, such that (sources of
water, and methods of waste disposal) had a weak relationships, except the distribution
of source of water, which representative that persons consumption water "Liquefaction"
are accounted better responding than other consumption's sources. As well as, moderate
degree of knowledge concerning cholera disease are presented in this study, as well as
most of the studied persons had good attitudes concerning cholera disease, which could
be interpreting hereditary of life style standby that level indeed.

Breast cancer is the most common malignancy and is real general well-being issue for
ladies all through the world and in Iraq. Breast cancer is an extremely heterogeneous disease,
There are three predictive markers: estrogen receptors, progesterone receptors and Her2-neu
receptors have independent prognostic value in breast cancer. ER expression appears in 80-90 %
of patients with breast cancer, while PR expression appear in 70-80 % of cases.Her2-neu over
expression present in 15-20 % of cases(1). Our study is a cross-sectional study carried out in Thi
qar governorate in Nasiriya city in Al Habbobi hospital –Oncology center, 165 cases of patients
who were diagnosed during the period of two years (February 2014 - January 2015 ) with
invasive breast cancer were included in this study . The information of each patient were
collected and analyzed which include : age of patient, sex, place of residence and tumor related
information include grading, staging of tumor, status of receptors(ER, PR, HER2neu receptors).
From this study we found The mean age 49±11.1. Most cases were PR+(75.2%) while
ER+(72.7%) but most of them were HER2 negative(78.2%). Most patients were in grade II
(64.2%) and stage II (50.3%) ,The most common hormonal receptor expression was (ER/PR+
,HER2-) which accounted for 64.8%.
Regarding to association of hormonal receptor expression with grading and staging of
tumor appears that higher grade tumor (II) was observed (76.93%) in type IV (ER/PR-, Her2+)
and higher stage (III) was observed (80.95%) in triple negative subtype.
Aim of Study:
It is to evaluate the hormonal receptor status and their association with grading and
staging of breast cancer at the time of diagnosis in Al-Nassiriya city.

Background :The effects of laser irradiation with 632.8 and 2100 nm on Erythrocyte
Sedimentation Rate (ESR) in blood samples from healthy peopleblood were
comparatively studied in vitro and study the effect of environmental temperature.
Objective : This study was designed to show the effect of He-Ne laser , HO-YAG laser
and effect of environmental temperature on Erythrocyte Sedimentation Rate (ESR) .
Subject & Methods : The study of case – control cross sectional design included
40healthy persons (male and female) with age group (20-45 year) , Workplace in the
laboratory of physiology and medical physicsthe time between April 2016 to July 2016.
He-Ne laser (LJL 40-HA, Shanghai Research Institute of Laser Technology) wave length
of 632.8ηm was used for irradiation with 5mm diameter beam spot on blood samples,
with power density 30mw/cm2 and HO-YAG laser irradiation wave length 2100nm
( Karl Storz – Endoskope , Germany ),output power is ( 0.5J) .The irradiation times were
(5min ) , The samples of blood were obtained from 40 contributors and each sample was
separated into three samples for irradiation and control .All statistical analysis was
performed withstatistical package graph Pad software For those with significant
difference.
Results :
The results showed that there were significant differences in the values of sedimentation
rates for both class (15 -45 ) 0c degree heat compared with the values of sedimentation 15
0
c 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 .We observe
irradiation 632.8 nm laser decreases ESR while irradiation at 2100 nm increases ESR
with p < 0.01.
Conclusion:The change of temperature (high and low) has a great effect on precipitation
of red blood cells in health people and thus must be taken into consideration and this
effect also observed with the use of632.8 and 2100 nm on Erythrocyte Sedimentation
Rate (ESR) in blood samples from healthy individuate blood were comparatively studied
in vitro at a temperature of 15 °C.We observe irradiation 632.8 nm laser decreases ESR
while increasing irradiation at 2100 nm with p < 0.01.

Background :
Low birth weight) less than 2500 grams) that includes preterm birth and small for
gestational age, is regarded as important causes of neonatal deaths and contributes to 60%
to 80% of all neonatal deaths.
Objectives :
to assess the frequency of deaths in low birth weight neonates and it’s relation to selected
neonatal, labour and maternal characteristics.
Patients and Methods :
A prospective study was carried out on low birth weight newborns admitted to neonatal
care units in Basrah Maternity and Children Hospital for four months( from 1st of
February till the end of the May 2008) on 508 newborns with low birth weight out of
1338 neonates admitted during the study period. One hundered-ninty one (191) neonates
with low birth weight died, their death was studied in relation to neonatal, labour,
delivery and maternal characteristics from data collection by special questionnaire.
Results :
It was found that (68.95%) of total deaths had low birth weight, male to female ratio was
(1.4:1). The death was significantly related to gestational age, weight, growth status
(being small for gestational age) and male sex. (P value was<0.001). The most common
causes of deaths were respiratory distress syndrome (54.97%) followed by sepsis
(19.37%. Other neonatal characteristics like postnatal referral, early death, and
hospitalization period of less than seven days, need for resuscitation at time of birth and
multiple pregnancies were associated with increased risk of death. (P value
<0.001).Hospital delivery, non-complicated delivery and normal vaginal deliveries were
associated with decreasing neonatal mortalities.(P value <.001).Young age mothers (less
than twenty years), Primgravidae, those who had anemia in pregnancy or had poor
antenatal care were more liable to have neonatal death ,while mortality rate was
significantly lower among breastfed neonates compared to formula fed babies.
Conclusions :
The frequency of low birth weight and their deaths were high, the death was related to
weight, gestational age, growth status, early neonatal period, complicated labour,
caesarean section, young primi mother and maternal anemia. Prevention of prematurity
and intrauterine growth retardation causes by good antenatal care, skilled attendance at
births, and availability of surfactant therapy can reduce mortality.

Background: Food handlers are the main source of Staphylococcal food poisoning in
developed countries.
Objective: The aim of this study was to determine the prevalence of the nasal carriage of
vancomycin resistant Staphylococcus aureus among food handlers in restaurants and
cafeterias, and to evaluate of antibacterial activity of cinnamon and ginger extracts against
these bacteria.
Material and Methods: A total of 100 nasal swabs were collected from healthy food
handlers and analyzed for Staphylococcus aureus ,methicillin resistant Staphylococcus
aureus (MRSA) and vancomycin resistant Staphylococcus aureus (VRSA) using standard
methods. Aqueous and ethanolic extracts of each plant were prepared by using a Soxhalet
apparatus and the antibacterial activities of these extracts against VRSA were determined
by using agar well diffusion method.
Results: of 100 nasal swabs, 30 (30%) isolates were Staphylococcus aureus , among which
25 (83.3%) isolates were MRSA, and 20 (80%) isolates among MRSA were VRSA. Both
plant extracts showed potent antibacterial activity against VRSA. Cinnamon extracts
showed higher antibacterial activity when compared with ginger extracts , whereas
ethanolic extract of each plant was more effective than that of aqueous extract.
Conclusion: This study revealed a relatively high prevalence rate of VRSA nasal carriage
among food handlers. Cinnamon and ginger are rich source of antimicrobial compounds
which can be used as natural food preservatives and to treat infections caused by these
bacteria .

Summary
This study aims to Evaluation of prolactin (PRL), thyroid stimulating hormone (TSH),
luteinizing (LH)and Follicle stimulating hormone(FSH)and trace elements (iron and
copper) in women with unexplained infertility (UI). 60 women with unexplained
infertility as well as (40) women with polycystic ovarian syndrome (PCOS) aged (20
35) year were included in this study. The women were divided according the type of
infertility into primary and secondary groups (1ºUI, 2ºUI, 1ºPCO and 2ºPCO)
respectively. Fifty healthy fertile women with the same age were included in this
study as a control group. The results showed a significant increase in serum of
Prolactin, TSH, LH levels in the two groups of women with explained infertility
(pcos) compared to control and the two groups of women with unexplained infertility.
In contrast no significant differences in Prolactin, TSH, FSH and LH levels in women
with unexplained infertility in comparison with the control.Serum levels of iron and
copper significantly increase in unexplained infertility groups in comparison with
women with explained infertility and control groups. This study concluded that is
Prolactin, TSH and LH hormone are not associated statistically with unexplained
female infertility. The increase in Cu and iron may have an important etiological role
in the pathogenicity of unexplained infertility.

Objective: This study aimed to assess the knowledge of traditional birth attendants
regarding
Immunization.
Methodology: This study was a cross sectional study conducted at wassit government , for
a period of 4 months extending from 1st of March 2015 to the 1St June 2015. The study
sample included 64 traditional birth attendants whose ages were 21 years and above. Data
collection was obtained by direct interview ( using the questionnaire form) . The Research
objectives are explained to TBAs and an emphasis on the confidentiality of information.
Results: forty-sixty (64) TBAs were included in this study, Significantly over 75% (48)
found in age >40 years. 21 (32.81%) had read and write level . They were predominantly
married, 67.19 %. In addition, They were residing in an urban area. Relative to length of
experience, the highest frequency of TBAs were in the length of experience of TBAs ( 51
<
) years was 53.13 %. nearly half of them (57.81%) were trained in the sectors of health.
High knowledge towards Immunizations was observed among (93.75 %) of TBAs
Recommendations: Depending on the high rate of TBAs’ knowledge concerning
Immunization recommend to train TBAs and utilize of them in the provision of advice on
Immunization, especially in rural areas. Consolidation of relations between TBAs and health
sectors, because of the significant impact on the high level of disease prevention, through
seminars,
lectures
and
open meetings.

Manual vacuum aspiration ( MVA ) or Karmah Cannula is a soft flexible Cannula
invented by Harvey Karman in early 1970s . This can be performed under local anesthesia
in the setting of a treatment room and office .
The aim of this study: To assess the efficacy of MVA in the management of first
trimester early fetal demise , missed abortion up to 13 weeks and incomplete miscarriage,
and it if can be used as successful alternative to traditional method of sharp surgical
curettage
Material and method: This was an interventional prospective study including 200
patients who were scheduled to undergo MVA for 1st trimester early fetal demise and
incomplete miscarriage . The study population consist of 200 patients who were diagnosed
as having missed abortion by ultrasound abdominal and Trans-vaginal ultrasound. The
study conducted between January 2014 – until January 2016 . The efficacy assessed by
completion of evacuation evaluated immediately by ultrasound conducted in the same
clinic and second look ultrasound after one week of the procedure .
Result: Efficacy of the procedure was 99% and incomplete uterine evacuation was seen in
1% of patients .
No significant rate of complication like uterine perforation , infection ,
or excessive vaginal bleeding .
More than 99% of cases has a successful procedure and did not required any further
surgical or medical treatment 98% of women were satisfied with the procedure and they
will recommend it to others .
This study proved that MVA is super to the traditional use of D & C with metallic tools by
avoidance of hospital stay and general anesthesia and will decrease the daily work load for
medical staff.
Conclusion :
Manual vacuum Aspirator ( MVA ) is safe , effective and minimally invasive procedure
with low rate of complication .
Moreover , it can be carried our safely and effectively in office or medical clinic and no
need for hospital admission , occupying the operating theatre and medical staff
involvement. It even cost effective in comparism with surgical dilatation and curettage
which is held under general anesthesia in operating theatre of Hospitals .
Recommendation: This study may change the traditional use of dilatation and curettage
with metallic tools and replaced by MVA with avoiding of general anesthesia and the need
for access to the theater

Objective: This study aims to determine the presence of blood serum and follicular anti
zona pellucid antibody in two groups of sub-fertile women (explained and unexplained),
to evaluate the influence of these autoantibodies on ICSI treatment outcomes and to
interpret these findings according to the cause of subfertility treatment outcome.
Methods and Materials: This prospective cohort study included 45 sub-fertile women
who are divided into subgroups; that are the explained and unexplained groups. All
females underwent 45 IVF-ICSI cycles after a certain ovarian stimulation protocol, 45
reached the egg retrieval stage and 44 was reaching embryo transfer stage, at the Fertility
center in AL-Najaf Al-Ashraf city from October 2015 to November 2016. Women had
undergone thorough assessments (clinical history and full examination) and frequent
ultrasonography with basal hormonal level in cycle day two and hematological
assessment for AZA, hormonal assessments (E2), two days before retrieval. Also on the
day of oocyte retrieval, follicular fluid was centrifuged and freeze for assessing AZA
later. After 2 weeks, serum assessed for HCG to detect biochemical pregnancy.

Rationale:
A large proportion of child deaths had been accounted from neonatal deaths.
Mortality during neonatal period is considered a useful indicator of both maternal and
newborn health and care.
Aim of the study:
This study aimed to know the magnitude of IM, assessment of its distribution and
knowing of its main determinants
Subjects and method
A cross sectional observational study extending all over the past 2 years; from
January 2106 till the end of august of 2017 in Bint Al-Huda maternity and pediatrics
hospital-Thiqar-Iraq, through which 1188 deaths had been included, where age by
days, sex,date of death, address, day by the week, word, time of inward admission,
cause of death and lastly comorbid condition. Frequencies, percentages, figures, chi
square test, fisher exact test, Univariet and mulivarient analysis had been used in
order to reach the proposed aims. P value of less than 0.05 consider as significant.

Background: Postmenopausal Osteoporosis is one of the most common causes of primary
osteoporosis. For two decades, diffusion-weighted imaging (DWI) has been applied to the
evaluation of intracranial diseases, but technical advancement make it possible to apply DWI
measurements
to
extra
cranial
sites,
including
vertebral
column.
Objective: Using diffusion-weighted MR imaging technology to determine the DWI and ADC
values of lumbar vertebral body in postmenopausal women in correlation with the DEXA t
scores.
Patients and Methods: A cross sectional analytical studywas conducted at Al-Yarmouk
Teaching hospital in Baghdad city. A total of 80 postmenopausal women, was recruited from
subjects who underwent DEXA of the spine and categorized into three groups according to their
t-score: Normal BMD, Osteopenia, and Osteoporosis. Then MRI study done for all of them
including:
T1,
T2,
DWI,
and
ADC
value
measurement.