Thi-Qar Medical Journal

Background: The study examines the facts and employment of ANC among the
women in the reproductive age group in Al-Nasiriya city, ANC services is particularly
definitive for enhancing the effectiveness of services for childbirth and introduce best
pregnant women’s needs of ANC services.
Objectives: To assess ANC services in pregnant women to identify the level of ANC,
risk factor prevalence according to score among pregnant attend PHCC for ANC to
evaluate the state of each pregnancy, and prevalence, of risk factors.
Subjects and methods: Descriptive cross-sectional study from 15 of January 2018 to
the end of august 2018 complete the study, a total of 586 pregnant attending PHCC
for ANC in Al Nasiriya city, when I took the data from 9 PHCC of two sectors for 3
month and half month complete sample size, a questionnaire was distributed
according to modified Coop land score in addition to sociodemographic status include
educational level, socioeconomic level and occupational status, the data analyzed by
using SPSS version 23.
Result: According to Coop land score was obtaining as the following:
Low risk 355 (60.6%), high risk 121 (20.6%), extremely high 110 (18.8%), and high
risk (include high, extremely high risk) percentage occur more in 2nd trimester, the
UTI represent the highest risk factor 28.9%.
Conclusion: prevalence of low risk factors among pregnancy was more than half that
reported while high risk pregnancy less than a quarter and the extremely high
represent lesser than a quarter, that means need more facilities to improve the state of
ANC services in PHCC to more to encourage for attending PHCC and concentrate on
high, extremely high risk groups by giving specialized care through ANC and put a
plan for them to decrease both complication and death on the fetus and maternal.
Recommendation: study results mandate more facilities to obtain more information
that encourages pregnant to visit PHCC and put a plan for a high risk group for
specialized care.

Background: Skin diseases are a common problem wide world affecting both sex and all
age groups, there are many factors contribute to cause skin diseases such as contact with
infectious patients, contact with an allergen or other irritant materials, overcrowding, and
poor hygiene.
Aim: To study the epidemiology of common dermatological diseases in Al-Nasiriya city
in 2018.
Methods and materials: Cross-sectional hospital based study from first of March 2018
to September 2018. This work tried to study socio-demographic, determinant, specific
laboratory investigation of common dermatological diseases under a well-prepared
questionnaire. The analysis of data was done by-SPSS version 25
Result: A total of 1048 patients had been studied where the extent of eczema/dermatitis
38.3%, viral infection20.4%, and protozoal infection 14% regarding to the socio
demographic age had a significant association in multivariate analysis.
Conclusion: eczema /dermatitis, viral infection, protozoal infection had most extent of
dermatological diseases.
Recommendation: further studies are required to identify preventive measures and
establishment of the dermatological center.

Background: The study aimed to estimate the prevalence of positive autoantibodies (Anti-GAD,
IAA) among (T2DM) as T1DM especially in elderly DM patients in a sample of the Iraqi
population, and to compare some metabolic and inflammatory markers to those of patients having
negative autoantibodies. Methods. 56 Patients with T2DM and 21 control participants 60 or older
than 60 years were enrolled in this study. Antiglutamic acid decarboxylase GAD, and insulin
autoantibody IAA, and C peptide, were evaluated by ELISA. Fasting blood sugar, Random blood
sugar, BMI, cholesterol concentration, triglyceride concentration systolic and diastolic blood
pressure were assessed, in addition to considering demographic characteristics. Results. 3% of
patients with T2DM had both anti-GAD and anti-IAA autoantibodies, 10(15%) and 7(10.8%) of the
patient were positive for two antibodies respectively, however, none of healthy control group have
one of them. The mean duration of initiation insulin up taking by bearing autoantibody group, was
(60±38.7 months) and in -ve antibody, group was (48 ±53 months) but these differences were not
significant (P=0.56) . there are no significant differences in the median age (P =0.80), BMI
(p=0.4218), main cholesterol concentration. (p=0.57) and C peptide (p=0.091) between +ve and
ve autoantibody bearing T2DM. +ve patients had lower body mass index (p=0.014) than those in
ve autoantibodies cases. Conclusion. Prevalence of having positive autoantibodies within Iraqi
T2DM patients 60 and over 60 years old was 3%. They shared common clinical and metabolic
features with subjects with non antiGAD, and IAA autoantibody bearing subjects.

Abstract:
Resistin, is suggested as an important factor in pathogenesis of insulin resistance
associated with obesity, and so might lead to development to T2DM. We want to verify
the correlation between resistin and glycaemic parameters and marker of obesity in Iraq
T2DM patients.
Aims:
To test the association of resistin with BMI and insulin resistance in T2DM.
Methods:
In this study 400 participant’s was included divided in to two groups (200) T2DM
patients and (200) healthy control persons. The biochemical and anthropometric
parameters included are body mass index (BMI), fasting resistin level, fasting blood
glucose (FBG) ,HOMA-IR and fasting insulin level.
Results :
The positively significant correlation between resistin and BMI (r = 0.939,
p<0.0001), insulin (r = 0.917, p < 0.0001), FBS(r = 0.966, p<0.0001) and HOMA-IR (r
= 0.947, p<0.0001) in T2DM were noted.
Conclusion :
Resistin might be consider as potent link between obesity, insulin resistance
and diabetes through disruption the signaling pathway of insulin that may lead to
development of insulin resistance and diabetes.

Background: Effectiveness of public health is determined by many indicators one of
them is the neonatal mortality rate that considers an important one for these issues, it
gives an impact on child health care services and welfare initiatives.
Rationale: Neonatal deaths account for a large proportion of child deaths. Mortality
during neonatal period is considered a useful indicator of both maternal and newborn
health
and
care.
Objectives: This study aimed to know the time trend of neonatal mortality in Thi
Qar, assess its distribution according to its main causes of death.
Subjects and Methods: Across sectional observational study extending all over the
past 5 years; from January 2015 till the end of June of 2019 in Bint Al-Huda
maternity and pediatrics hospital-Thi-Qar-Iraq, through which no. of live birth,
neonatal deaths had been included, where sex, address, word, cause of death and
lastly comorbid condition. frequencies, percentages, chi-square test, Fisher exact test,
Univariate and multivariant analysis had been used to reach the proposed aims. P
value of less than 0.05 is considered significant.
Results: Even though there was a difference within a number of live birth all over the
five years of the study, but it was no so big and statistically non significant (P value
=0.163). The numbers of deliveries per month and seasons had significant statistical
differences where P value (0.042). A rate of mortality is increasing by nearly 175%,
148 % between the year 2015 and 2019 for both ENMR and LNMR. Respiratory,
prematurity, and congenital anomalies were the main causes of death all over the five
studied
years.
Recommendations: Big efforts must be exerted upon full details of neonatal death to
clarify its risk, causes and reducing its big burden on the health care services by
prevention of this mortality rate.

Background: The post-operative fluid therapies are considered a key part of surgical care
and have attracted more attention and importance over the last period because of their
remarkable impact on post-surgical outcomes. Several studies showed inappropriate and
suboptimal therapy of intravenous fluid and associated with many compactions such as
Weight gain due to fluid overload and electrolyte abnormalities. Therefore in 2013, a new
guideline had been initiated by the National Institute of Health and Care Excellence dealing
with fluid therapy in adults. This study aims to assess the current practice of fluid therapy
versus the guideline.
Methods: The study was a prospective observational with 105 patients match the eligibility
criteria and only 84 are included. The patient‟s body weight, amount of fluid given to patients
were calculated and compared to guideline also, serum sodium and serum potassium
measured before and after fluid therapy.
Results: The main results of this observational study demonstrated that the amount of fluid is
significantly higher than the recommended amount by a guideline and lack of correlation
with the body weight. Also, the body weight increased and serum potassium decreased
significantly after two days of fluid therapy. Increased incidence of electrolytes abnormalities
and trend of use of more saline containing fluids with less ringer was also observed.
Conclusions: The data of current practice collectively indicated that extra amounts of fluid
were prescribed resulted in increasing body weight of patients and appearance of electrolytes
disturbances.

Background: Fractures are a common type of injury that result in admission to a hospital.
Patients and Methods: The study was held in Kirkuk city - Iraq, Azadi Teaching Hospital from
the beginning of November 2012 to the end of April 2013. A descriptive case series study with a
total of 4156 patients with 5248 confirmed fractures formed the basis of this study. The term
type of fracture used in this study signifies either simple (closed) fracture or compound (open)
fracture. Associated injury comprised head injury, chest injury, abdominal injury, vascular and
nerve injuries. The term multiple fractures were used if more than one fracture has occurred.
Hospitalization of a patient meant those who were required to stay in the hospital for more than
24 hours, and others were taken as outpatients. The diagnosis was mainly based on an X-ray.
Results: The study revealed that multiple fractures are more seen in age group (20 - 40) years,
followed by age group less than 20 years was (31.3%), The commonest three fractures
encountered in this study were those of radius (21.8%), tibia (18.3%) and ulna (12.5%).so
current study determined that highly frequent fractures among age group (20 – 40) year's old
patients were tibia fractures (18%), radius fractures (17.4%), and ulna fractures (13.5%). , so
frequencies of fractures among males (75%) more than females (25%). As well as fractures were
more frequent in an urban area (89.2%). Conclusion: the second age group (20-40) years were
the more frequent in fracture cases, also Fractures were predominant in males more than females,
Persons who lived in urban area had a high frequency of fractures, as well as workers and those
with a free job, are more prevalent with fractures, also upper limb fractures were more common
than lower limb fractures and axial skeleton fractures. so radius and tibia were the most
frequently fractured bones. And the higher frequency of fractures was associated with falls,
followed by road traffic accidents. city.

A prospective study carried out in Kirkuk city from February to October 2019, included 200
PCOS women who were enrolled attended Azadi Hospital to study the epidemiology the
infertility of PCOS women underwent ICSI and their related outcomes. All women were
subjected to the basic fertility work-up at the infertility center which consists of history
taking, physical examination, ovulation detection, evaluation of tubal patency and uterine
cavity. All couples subjected to a full history taking, complete general examination, complete
gynecological examination and infertility workup including: husband’s seminal fluid
analysis, basal hormonal analysis, uterine cavity assessment by ultrasound and tubal patency
evaluation by hystrosalpingogram. The females were divided into 2 groups each consists of
100 females. The control group did not receive any ovarian stimulation drugs (natural cycle).
In cases group, ovulation induction programs were used were stimulated by Clomid +
gonadotropin. The ovarian stimulation protocol was chosen for each patient according to her
age, history of stimulation treatment in previous cycles if present, hormonal assay and
ultrasound finding in the early follicular phase. The study showed that the higher number and
percentage of infertile PCOS women 33% at age 20-29 years. The study demonstrated that,
majority of patients PCOS women were belonged to urban area. The study demonstrated that,
75% of PCOS have irregular cycle and 65% more liable for PCOS have (5-7) days of
menstrual flow. The study showed than majority of studied women haven’t family history of
PCOS (60%). The study showed that the highest mean of age were recorded among PCOS
women who were pregnant compared with non-pregnant women (33.67 v.s 31.55 year) (P: >
0.05). The highest mean of BMI were recorded among non-pregnant women compared with
pregnant women (26.55 v.s 23.45 kg/m2), the result was significant (P<0.01),

A case control hospital based selective study was done on 100 children with PUO who
admitted to the Karbala Pediatric Teaching Hospital in Karbala city, during the period from
1st of March 2018 to the last of March 2019 aged from 2 months-5 years. A comparable
group of similar number of cases of apparently healthy children was taken as a control group.
This study aimed to evaluate the diagnostic value of CRP and PCT pyrogenic of unknown
origin (PUO) in relation to some hematological parameters.
The study included the collection of 3 ml of blood from each patient and control for
assessment of PCT and CRP by immunofluorescence and hematological parameters by
general auto-analyzer hematology. This case control study included 100 children with PUO
(60 males and 40 females), their age range was 3-48 months (mean: 17.12±8.2 month), the
study also included 100 healthy children (as control group) with the same characteristics of
the patient. The study revealed that the highest mean level of PCT was recorded
among children with PUO (17.36 ng/ml) and the lowest level mean level was found in
healthy children (3.56 ng/ml). The study also exposed that the highest mean level of
CRP was recorded among children with PUO (22.6 ng/ml) and the lowest level mean
level was found in healthy children (2.11 ng/ml). The study showed that WBCs, neutrophils
and lymphocytes counts were elevated significantly among children with PUO as compared
with healthy children. The study revealed a significant positive correlation between PCT and
CRP among children with PUO (r: 0.84, P<0.001), and a significant positive correlation of
PCT and CRP with each of WBCs, neutrophils and lymphocytes counts among children with
PUO. It was concluded that there a significant positive correlation between PCT and CRP
and significant positive correlation of PCT and CRP with each of WBCs, neutrophils and
lymphocytes counts among children with PUO

BACKGROUND: Immunosuppressive drugs is the main cause of Post-transplant
diabetes mellitus, which consider as one of the highly commonest transplant
complications.
Aim: To assess the Post-transplant diabetes mellitus incidence and determine the
other factors which may play a role in this complication development.
Method: 105 non-DM study population included in this study transplanted renal
allograft, since 1999. Post-transplant diabetes mellitus was identified by the
requirement of the hypoglycemic drug which started after transplantation by a range
of more than one month. All patients after transplantation received prednisone and
cyclosporine and no one received tacrolimus.
Results:
At 1st, 3rd, 5th, and 10th years follow up after transplantation, five, eight,
eleven and lastly nineteen percent developing Post-transplant diabetes mellitus., the
correlated variables was determined as independent variables for the rapid increment
in the Post-transplant diabetes mellitus numbers, which, higher BMI- before
transplant, age of recipient the younger than 45 years significantly differ from
older age with P < 0.0001
Conclusions:
Post-transplant diabetes mellitus risk continuously increases with
post-transplant time. Transplanted patients show increment in Post-transplant diabetes
mellitus incidence whose recipients characteristics changes is the full explanation of
this matter. The assumption of a cause of this increment is due to the introduction of
better absorbed CsA formulations, which resulted in higher diabetogenic drug
cumulative exposure in addition to other factors.

Background: a role for dietary omega-3 fatty acids in reducing systolic and diastolic
blood pressure, which might be more or less among diabetes type 2.
Aim: To determine the effect of omega-3 supplementation on blood pressure in
patients with type 2diabetes.
Method: A single-blind, controlled clinical trial on patients admitted to Nasiriya
Diabetes Center was involved randomly to 2 groups receiving either 2 g/day omega-3
and the comparator group received the same consultations exactly as the intervention
group but provided anon-specific intervention. Our study period was 6 weeks.
Participants were asked to follow the same lifestyle programs (physical activity, diet,
and routine medicine) during an intervention, at the beginning and last of the study
blood pressure were measured out and compared.
Results: Out of 60 participants 56 completed the study and 4 patients were excluded.
Age, body mass index, SBP, DBP, and duration of diabetes at the beginning of the
study in both groups. No significant difference was observed in baseline variables.
43% of the intervention group and 36% among the comparator group were diagnosed
with hypertension. systolic and diastolic blood pressure in both groups was not
statistically significant before and after the intervention.
Recommendation:
Consumption of 2 g/day omega-3supplement for 6 weeks has no significant effect on
systolic and diastolic blood pressure in diabetes mellitus type2.

The CPPS is nearly the commonest controversial topic in urology with the emerge of a new
modality of management by shockwave therapy. The aim of the study to assess the long term
efficacy of CPPS treatment by ESWT, where patients with non-bacterial type prostatitis. The
study was conducted on 120 CPPS patients where they were randomly dispersed into the sham
and treatment groups and evaluated at 8th, 24th, lastly on 36th weeks. A treatment group of
patients was managed by ESWT once a week for 6 weeks using LUBIS-ONE (mode A, level
5/5-10min.). While the second group (sham group), there was an application of the same
protocol without firing probe. The pain visual analog scale was used for follow-up assessments.
Patient Global Impression of Improvement (PGI-I) and "National Institutes of Health-developed
Chronic Prostatitis Symptom Index" (NIH-CPSI). independent t-test was used for data
comparison and analysis of variances. In this study, nine patients only cannot complete the
protocol of the study, hundred eleven patients were evaluated (fifty-seven patients as a treatment
group, while sham group was 54 patients). At the 24th week of follow-up, the mean urinary
score, pain score, NIH-CPSI score and between quality-of-life two groups were of non
significant statistical difference. While, ESWT therapy has been established as a non-invasive
effective mode of therapy in CPPS in following-up for short-term, long-term efficacy was not
supported by this study.

Background: Depression is one of the most common mental health
conditions in the general population as well as in clinical practice. In
clinical studies, there is a strong relationship between gastrointestinal
symptoms and depression and the gastrointestinal symptoms remain for
longer time and are more serious than in patients without depression.
Objective: To estimate the extent of depression in gastrointestinal tract
symptoms in medical outpatient clinic attendees.
methods: The study was a cross-sectional analytical study for 154 adult
population in the Al-Hussein teaching hospital in Nasiriya city ,
conducted at first March 2018 and completed at end of September 2018.
Tools of the method were questioner and for diagnosis of depression was
used Diagnostic and Statistical Manual of Mental Disorders, fourth
edition (DSM- IV) criteria. the refusal rate was zero and for statistical
the analysis was used SPSS version 22.
Result: The study showed that 43.5 % of subjects with gastrointestinal
symptoms suffer from depression. depression was found in 40.7% of
females and 47.1% of males. 50.0% of depressed patients were in two age
groups of 20 -44 years and ≥ 65 years.
Most depressed patients were suffering constipation (51.3%), change in
appetite (51.3%), and change in weight(50.7%), where only change in
appetite had a significant association with depression, were p
value=0.001. More depressed subjects had GI symptoms with one-month
duration and ≥7 numbers of GIT symptoms.
Recommendation: Raising awareness of the general population about the
depression and relation of that with GIT symptoms.

Background: Amblyopia is also called lazy eye, it is a faintness in the central vision of
the eye, without an organic cause, or in a way that is not commensurate with the organic
imperfection in the eye.
Aim: The study aimed to evaluate the efficacy of OCT technique in the diagnosis of
RNFL thickness in amblyopic patients.
Material and method: A prospective cross-sectional hospital based study was performed
in Al-Najaf Al-Ashraf province/Iraq through the period from January to September/2014.
The study involves 30 patients (16 male and 14 female) with the age ranging from (10
40) years who suffering from unilateral amblyopia.
Result: The thickness of inferior peripapillary RNFL was recorded thinner than those of
normal eyes significantly with p-value ≤ 0.05. But, peripapillary RNFL thickness in
nasal, superior and temporal types have no significant differences when compared with
normal eyes.
Conclusion: In brief, our results suggested that the peripapillary RNFL thickening was
significantly affected in strabismic and anisometropic amblyopia. Further, instrumental
and histo-pathological studies are required to confirm the differences between amblyopic
and normal eyes.

Background:
Intrauterine contraceptive device (IUCD) oral contraceptive pills (OCP) are widely used
contraceptive methods by women. Some concerns had been raised about the role of IUCD and
OCP in the development of cervical dysplasia and cancer. And cervical cancer is the fourth most
frequent cancer in women, with over half million new cases reported each year.
Objectives:
To evaluate the effect of IUCD and OCP use on pap-smear results among women in Karbala
city. And to assess some factors associated with cervical dysplastic changes.
Subjects and methods:
A case–control study. Three groups of women were categorized according to the use of OCP,
IUCD, or other contraceptive methods for one year accordingly. Pap smears were taken for them
and reports were reviewed by a consultant cytopathologist. A total of 237 cases were collected.
Results:
The three groups had no significant difference in age, parity, or duration of contraceptive method
used. Most Pap smear results were normal, 29 (12.2%) had inflammation and only 7 (3%)
showed dysplastic changes and no malignancy change identified among the sample.
Inflammatory changes were more prevalent among IUCD users while benign dysplastic changes
were more prevalent among women who used other methods of contraception. Dysplastic
changes were significantly associated with older age of above 35 years.
Conclusion:
No association between OCP and IUCD use with abnormal pap-smear results as a significant risk
factor for cervical cancer. Inflammatory changes were more prevalent among women who use
IUCDs. Dysplastic changes are associated with age over 35 years

Background:The spread of Nargile smoking is widespread, especially among young people who
visit Nargile cafes. Unfortunately, most Nargile smokers appear to have little information about
potential health problems of the heart and blood vessels and other outcomes of Nargile smoking.
Objectives: This project was designed to investigate the sociodemographic data of the study
sample of Nasiriya people (like age, gender, academic achievement, and job), smoking habits,
and the impact of smoking nargile on the health (including physical changes, and psychogenic
changes).
Materials and Methods: A cross-sectional study was carried on 400 healthy Iraqi citizens who
are smoking Nargile in the Iraqi Cafes and restaurants in Nasiriya city. The volunteers aged 15
50 years were recruited during the period from April to July 2019 in Nasiriya to participate in
this study. All volunteers were provided with oral consent to participate in the study. Materials
include queries about data, the use of current Nargile, and habits of Nargile smokers, the impact
of Nargile on health including physical changes, and psychogenic changes. The questionnaire
will be presented to the volunteers and asked to answer the required data, the information is
filled by the researcher.
Results: Most of the Nargile smokers were males 95.75%, with a mean age of 28.49±7.55 years,
83.75% were regular smokers of Nargile, and 86% smokes for more than one year.
Conclusion: According to this study, youth were the most smoking age group for Nargile with a
few underage users. Interventions to reduce Nargile use should provide real information about
the health risks of Nargile use.

Background: Insulin resistance, obesity, sedentary lifestyle and type of food are considered to
be a causative agent for predisposing of T2DM.
Aim: To investigate the correlation between insulin resistance with BMI and the effect of
Visfatin in this interaction (T2DM).
Method: This project has two groups, a control healthy group consist of 200 volunteers and a
second group of 200 T2DM patients who were documented according to WHO criteria.
HOMA-IR, FBG and BMI were measured.
Results: A significant relationship between T2DM and IR was observed, additionally to a
significant relationship between visfatin level and blood glucose level.
Conclusion: T2DM is associated with insulin resistance which has many predisposing
factors like obesity, sedentary lifestyle and type of food style, visfatin is an adipokine with an
insulin-mimetic action that tends to increase insulin sensitivity and reduces blood glucose
level and this clarifies the elevated level of Visfatin in such T2DM.

Objective: of this study to study the effect of age and specific age groups in the
distribution of breast mass in Thi-Qar, to determine the effect of most determinant
factors included in obstetric history on that distribution, and to assess the validity of
radiological investigations and FNA about histopathological diagnosis of breast
masses for patients counseling breast disease clinic in Thi-Qar 2018.
Design:
A
cross
sectional
analytical
design
was
used.
Patients: All women presented with breast mass at defined age, were included.
Results: The rate of malignancy increased with age; at ages >45 years about half of
cases were malignant (47%), and constitute(57.4%) of the total malignancies, while
the other ages categories of < 45 years, the proportion of malignancy among cases of
the same categories about (16%), and constitute (25%), (17%) for ages interval (30
45), (<30) respectively On other hand FNA are 82% specific and 96% sensitive
compared to definitive histopathologic results in the diagnosis of breast masses.
Conclusion
The findings of the current work suggested that age was a strongly correlated factor
and about 57.5% of the malignancies were above 45.
FNA are 82% specific and 96% sensitive in relation to definitive histopathologic
results.

Background—The urokinase type plasminogen activator receptor (uPAR) may play a critical
role in cancer invasion and metastasis.
Aims—To study the involvement of uPAR in colorectal carcinogenesis.
Methods— fourty four cases of colorectal adenocarcinoma were obtained and diagnosed as
colonic carcinoma with it's grade received as formalin-fixed, paraffin-embedded tissue in AL
Nasiriyah teaching hospital with cases of carcinoma also 6 cases of normal endoscopic
biopsies used as control –ve and 10 cases of adenoma with dysplastic changes all these cases
stain by immunohistochemical methods for expression and localisation of uPAR.
Results_ all the cases of endoscopic biopsies were –ve for these receptors so used as –ve
control, while cases of adenoma 3 out of 10 cases showing focal positivity in areas of
dysplasia, while the cases of invasive carcinoma showing diffused positivity and the case
percent of positivity depend on grade so high grade tumor showing a high percentage of
positivity.
Conclusions—Colorectal adenoma uPAR, expressed essentially in dysplastic epithelial cells,
was upregulated with increasing severity of atypia, and increased notably during the critical
transition from severe dysplasic adenoma to invasive carcinoma. These findings implicate
uPAR expression in the invasive and metastatic processes of colorectal cancer.

Abstract :
Background :
A nasal polyp is the most common mass lesion encountered in the Nose, Described as an
abnormal lesion that emanates from any portion of nasal mucosa or paranasal sinus.
Sino-nasal mass of another histological origin can be difficult to distinguish from nasal polyp
based on symptoms, Nasal endoscopy and computed tomography. The nose and paranasal
sinuses represent two of the rarest site of origin of head and neck cancer but also give rise to a
great variety of different histological types.
Setting :
The prospective study planned achieved in hospital of specialized surgeries, department of
Otorhinolaryngology from April 2007 to November 2008.
Objective :
To analyse the causes, the clinical presentations of unilateral sinonsal mass.
Patients and Methods :
The study involves 64 patient attended the outpatient department of Baghdad teaching hospital
and Basrah general hospital department of otorhinolaryngology complaining of nasal symptoms
with variable presentation. All the patients were assessed by a thorough history and clinical
examination. Some of them had been sent for radiological investigation and imaging study and
underwent incisional or excisional biopsy then send for histopathological examination.
According to the clinical and radiological findings, we divide the patients into 2 groups.
 The 1st group has no significant associated clinical finding nor radiological evidence of bony
erosion called inflammatory.
 The 2nd group have significant associated clinical finding like Epistaxis, facial pain, paresthesia
and radiological evidence of bony erosion and called neoplastic. Then compare that with the
histopathological results.
Results :
In this study the total No of patients 64 – 41 male and 23 female. Thirty-five of them were found
to have inflammatory mass. Twenty-nine of them were found to have neoplastic mass.
 The commonest inflammatory lesion was simple nasal polyp 25.
 The commonest neoplastic lesion was angiofibroma as benign and squamous cell carcinoma as
malignant.
 The commonest presentation in the neoplastic lesion is epistaxis followed by facial pain.
 The commonest presentation is unilateral nasal mass is nasal obstruction.
Conclusion: We found that a considerable percentage of unilateral sinonasal mass was
neoplastic both clinically and histopathologically.

ABSTRACT
Background & Aim
Medical records documentation is an important legal and professional requirement for all health
professionals to ensure that the medications prescribed for patients contribute to the best possible
health outcomes. The main objective was to assess the documentation completeness level of the
medication sheets in the different inpatient wards of Iraqi hospitals, also to identify trends of
clinical pharmacist intervention towards problems related to drugs, and to estimate physician’s
acceptance status of the proposed intervention.
Method
A retrospective study was conducted in a number of randomly selected hospitals as a
multicenter; the sample consisted of number of randomized medication summary sheets per
ward, recorded during the medication order validation process and drug-related problems were
identified. Patient’s demographic characteristics, drugs administered, drug-related problems
description, pharmacist’s recommendations, and whether or not the recommendations were
accepted by the physician or not were recorded.
Result
A total number of (562) medication sheets collected from multiple wards of different hospitals,
pharmacist intervention represent (23.5%) of total medication sheets across multiple wards from
3 hospitals. Medication sheets of the emergency and CCU included the majority of pharmacist
interventions (64.4%), followed by medication sheets of a surgical ward (18.9%), and the least
intervention was found among medication sheets of the internal medicine ward (16.6%). Drug
related problems that may arise in hospital settings are mainly dispensing errors (32.65%),
unavailability of an indicated drug (15.64%). A total of 295 counseling and recommendations to
patients and health care providers at the physician, nursing staff levels were implemented and
documented. This retrospective pilot study confirmed the obvious incompleteness of
documenting the majority of clinical pharmacist medication sheets for the inpatient particularly
in the surgery ward.

Summary
Few prognostic biomarkers have been identified for prostate cancer and there are clinical
difficulties in distinguishing between relapsing and non-relapsing diseases. The aim of this study is
to investigate the hypothesis that ABCG2 might be a potential biomarker for prostate cancer and
could distinguish between aggressive tumours requiring radical intervention and those that have a
good prognosis. ABCG2 is a transmembrane protein that plays a vital role in promoting
proliferation and maintaining the undifferentiated phenotype of stem cells. It is thought to be a
potential biomarker that can predict clinical progression and prognosis of different kinds of tumors.
However, its role in prostate tumor remains unclear.
Nuclear and cytoplasmic ABCG2 staining has been evaluated by immunohistochemistry using two
sources of patient samples. The tissue microarray group consists of 96 cases including normal,
adjacent normal and malignant prostate tissue samples. The Bath cohort consists of 30 samples,
including samples from patients that had recurrent disease and those who remained disease-free.
The immunohistochemical study showed nuclear and cytoplasmic ABCG2 expression in benign and
malignant prostate samples. Cytoplasmic ABCG2 expression was also significantly reduced in
prostate cancer compared to normal tissues. Cytoplasmic ABCG2 staining was negatively
associated with increasing Gleason grade. In the Bath cohort, there was a negative association
between ABCG2 expression and biochemical relapse. This preliminary data showed that ABCG2
might play a role in cancer formation and/or aggressiveness and warrants further investigation to
understand its function and establish if it could be a potential diagnostic biomarker for prostate
tumour.