Thi-Qar Medical Journal

Background:
Coronavirus disease 2019 (COVID-19) is a widespread illness caused by the coronavirus 2 that
causes severe acute respiratory syndrome (SARS-CoV-2). We intend to investigate the clinical
characteristics and symptom status of SARS-CoV-2 patients.
Method:
We collected clinical data of 381 patients infected with SARS-CoV- 2 from early-June to mid
August 2020. Biological markers analyzed in this study include: PCRct value, CR-Protein, D
Dimer, LDL, and Troponin-I regarding the signs and symptoms for all patients enrolled in this
study.
Results:
Among 381 confirmed COVID-19 patients (166 males, 160 females), that divided into two
groups; 213 who received vaccination (single dose or booster mRNA vaccination), and 139
patients who did not receive vaccination. The significant differences were reported in the first
week and second week of infection for both vaccinated and unvaccinated patients that reported
for both cases (pv<.0001). Importantly, there were a significant differences reported in the
symptoms for both group in the first and second weeks of infection that were (pv=.0001). The
study reported that the D-Dimer was significantly elevated in both groups of the study, which
were (pv=<0.0001) for both group. While, there is no significant differences between the two
group that reported in the first and second week of infection with (pv=0.9974). Significantly,
CR-Protein in vaccinated COVID-19 cases was (pv=0.0001) similar to that of un-vaccinated
COVID-19 patients. Hence, the symptoms, Troponin, D-dimer, CRP level were higher in
COVID-19 patients in the second week during laboratory analysis including hospitalized
patients. Significantly, high LDL level in the second week and especially in female were
considerably reported in this study.
Conclusion:
Clinical markers have a crucial role in determining the prognosis for SARS-CoV-2 patients, and
vaccination effectiveness helped to reduce the severity of the virus's signs and symptoms.

Background: Infectious diseases, often known as communicable diseases, are disorders brought on by
the invasion of body by particular microorganisms such as viruses, bacteria, fungi, and parasites, Main
causes of death worldwide remain communicable diseases, which account for a significant portion of the
annual death toll.
Aims: assess teachers' awareness about control of communicable diseases, assess awareness of teachers
about immunity and vaccination, and find the relation between demographic characteristics and
teachers’ awareness.
Methods: Descriptive cross-sectional study that was carried out between the March 2022 to September
2022, The study was conducted in primary schools of Al-Swaira city which include (120) teachers from
(7) primary schools out of (25) total primary schools, data analysis approaches were used in order to
analyze and assess the results of the study under application of the (SPSS 23).
Results: Study show socio-demographic characteristics in the teachers of primary schools. Age (34.2%)
of them were (31-40) years old, (65.8%) of them were female, (68.3%) were diploma of educational
level, show highly statistical significant association between teachers’ awareness about control of
communicable diseases and immunity and vaccination.
Conclusion: Study discovered that all of the items related to awareness of teachers about control of
communicable diseases most of their answer were always, half of the items related to awareness of
teachers about immunity and vaccination all of their answer were always.

The endoscopic sinus surgery is one of the main surgical procedures in field of rhinology, in
addition the endoscopic uncinectomy considers as the gateway for the maxillary sinus opening.
However, there are many techniques to perform uncinectomy in various scientific articles such as
Stammberger classical method and Swing -Door strategy which was emerged in 1998 via Professor
P.J.Wormld .(1).
This is a simple comparative study to compare between different uncinectomy procedures.

Background:
COVID-19, also known as the new coronavirus, has been linked to a variety of clinical
outcomes, including moderate respiratory symptoms, severe respiratory failure, multi-organ
failure, and death. The disease's severity can vary depending on a number of factors, including
age, pre-existing medical disorders, and immunological function.
Aim:
The aim of this study was to monitor the 25OH-Vitamin D serum level with clinical outcomes
including CRP for patent’s infected with SARS-CoV-2.
Method:
In this study a total of 59 patients and 25 normal cases (for control) were enrolled for
investigation the role of Vitamin D in the disease severity in patients infected with SARS-Cov-2.
Results:
The result showed a significant decrease of vitamin D in abnormal group compared with normal
group (15.74±5.63 vs 33.41±12.18 ng/dl, p = 0.0001). Additionally, the patients in infected
group (6.7±12.64) had significantly (p<0.0001) lower CRP level in comparison with control
group (1.77±3.12). There are no significant differences reported (0.612) in ages between the
infected COVID-19 group 38.35±6.15 and control group (37.85 ± 7.28). Furthermore, The RT-
PCR had no significantly reported differences between COVID-19 cases and control group
29.98±5.25 vs 39.89 ± 5.01.
Conclusion:
we found that COVID-19 patients with vitamin D deficiency were more likely to increase the
risk of severe COVID-19 infection and complications; it helps regulate the body's inflammatory
response, which is important in fighting off infections.

Background:
Cutaneous warts are a common viral infection of the skin caused by the Human Papillomavirus
(HPV). These warts are characterized by raised, rough, and sometimes painful growths on the skin.
Cutaneous warts can occur in various parts of the body, including the hands, feet, and face (1).
While cutaneous warts can affect individuals of any age and sex, there is evidence that the
prevalence and incidence of HPV infection and cutaneous warts may differ between males and
females (2). The molecular detection of cutaneous warts among male and female patients in Thi
Qar Province aims to investigate the prevalence and distribution of HPV strains associated with
cutaneous warts in this population (3). Cutaneous warts are caused by infection with Human
Papillomavirus (HPV), a DNA virus that is transmitted by direct contact with infected skin or
fomites. There are over 100 types of HPV, and certain types are more commonly associated with
cutaneous warts than others. The most common types of HPV associated with cutaneous warts are
HPV 1, 2, 3, 4, 27, and 57. HPV infects the basal cells of the epidermis, and viral replication results
in the formation of hyperkeratotic, acanthotic lesions (3). This information can inform strategies for
the prevention and treatment of cutaneous warts in this region (4).

Background: The B19 Human Parvovirus is an icosahedral virus with a single strand and no
envelope. A total of 5596 bases make up its DNA, which places it in the parvovirus family. The
deoxyribonucleic acid (DNA) B19 virus mutation has been linked to liver dysfunction in transplant
recipients and has been associated with an increased risk of developing liver disease. As a result,
scientists suspect that B19V has a negative role in liver damage, especially in instances of acute
hepatitis and acute liver failure of unclear origin, as well as in those with hepatitis B or C co
infection, all of which have a worse prognosis.
Methods:
From August 2022 to the end of February 2023. This study included the collection of serum samples
for the detection of Human Parvovirus antigen in 60 patients with viral hepatitis. Also included was a
control group consisting of 30 individuals of different ages who did not have viral hepatitis. All these
serum samples are detected for Parvovirus antigen by the enzyme-linked immunosorbent assay
method.
Conclusions:
According to the results of this study, it is first concluded that the presence of human Parvovirus in
patients with viral hepatitis was not influenced by most of the demographic factors studied. It is
found that there are no significant differences in the detection rate of human Parvovirus among
patients in terms of sex, age, residence, COVID-19 infection, or vaccination against COVID-19. The
study did find a 10% detection rate of Human Parvovirus protein antigen among patients infected
with hepatitis B and C viruses. Overall, the study suggests that viral hepatitis may play a role in the
prevalence of Human Parvovirus B19, but further research is needed to fully understand the direct
relationship between the two viruses that affect their prevalence in humans.

Objective
To examine the effectiveness & safety of Metformin vs. Insulin in the treatment of pregnancy
complicated by gestational diabetes mellitus (GDM) .
Design Open –labelled prospective randomized controlled study .Setting
Basra maternity and children( tertiary level) hospital in Basra city . Sample
121 women with GDM who did not attain normoglycemia with diet during the period
between January-December/2018. Method
Women were randomized to two groups :treatment by Insulin n= 60 & by Metformin
n=61.Main outcome measure
The efficacy &safety of the use of oral Metformin in controlling hyperglycemia among
women suffering from uncontrolled GDM by diet only; as compared to Insulin.

Background: The corona virus disease 2019 (COVID-19) is a pandemic health disaster leads
to high morbidity and mortality rates all over the world. The literatures concerning effect of
COVID-19 disease on pregnancy outcomes are limited.
Aim of study :
To evaluate the effect of COVID-19 on pregnancy during the antenatal, intrapartum &
postpartum maternal and fetal-neonatal outcome among infected women .
Patients and methods:
A prospective observational study done in Basra Teaching Hospital in Basra government/
south of Iraq during the period from 1st of March, 2020 to 28th of February, 2021 on sample of
one hundred pregnant women infected by COVID-19.The data were collected by direct
interview & filling a previously prepared questionnaire. The diagnosis of COVID-19 disease in
pregnancy and severity categorization was done by physician according to Iraqi Ministry of
Health guidelines for diagnosis.
Results: The COVID-19 severity in pregnant women was classified into; mild (60%),
moderate (26%) and severe (14%). 68% of participants had good final outcomes & 32% of
them had poor outcomes. 66% of fetuses of participants had good final outcomes & 34% of
fetuses had poor outcomes.
Conclusions: The COVID-19 in pregnancy leads to significant poor maternal & fetal
outcomes.

Background: Diabetes mellitus is a worldwide disease characterized by disturbance in insulin
secretion and or action. Type 2 is the most commen and burden the body with several complication
that may be eccelerated by un customized dietary intake.
Aim of the study is to check the relationship between the sex difference and meat and fat
consumption in type 2 diabetes mellitus patients.
Patient and methods
In this cross-sectional comparative study, 300 T2 diabetic patients selected randomly in diabetes
and endocrine center in Thi-Qar province/ Iraq from 1/4/2022-15/9/2022. 154(51.3%) patients were
male and 146(48%) patients were female, their age range from25-83, mean= 50.97. Age, sex,
residency, marital state, education, occupation, smoking, and the body mass index, dietary behavior
and anthropometric measures were checked, and we send them RBS,HbA1c, lipid profile and body
component examined by human body element analyzer (impedance electrochemistry). We use
SPSS program, p value (0.05 or less)was significant using ANOVA, pearson, chi square and X2 test.
Conclusion:
There is no effect of sex difference with meat and fat consumption in type 2 diabetes mellitus
patients.

Objectives: In order to evaluate the educational program of medical sciences in Thiqar College of
Medicine as part of this program evaluation process, we designed a student questionnaire based on a
definition of quality teaching of basic & clinical sciences and to identify its underpinning
dimensions. The study aims to survey the opinion of samples of students, graduates, and lecturers
about some of the specifications required in the curriculum and the academic program that meets
the requirements of accreditation by Iraqi (national standards for accreditation of medical colleges)
(NCAMC)
Subjects:
A total of 338 individuals (undergraduate students of four stages, graduates and lecturers), asked to
rate 17 of scientific and skill improving aspects questions about taken curriculum and followed
educational program.
Materials and methods:
the questionnaire was administered during the regular class period of 2018/2019 academic year. At
the time of the evaluation, officially authorized staff of evaluated activities weren't there.
Results:
Three identifiable parts involved on the questionnaire: instructional techniques, learning
evaluation, ethics, and response capability. About 22% of the respondents felt that basic science
courses lacked clinical relevance. The evaluations of the students' sufficient knowledge and clinical
and professional skills to assume appropriate responsibility after graduation weren't particularly
positive (48.2% negative). Exposure to several activities was rated by respondents as being
inadequate (student- centered teaching, critical thinking & lifelong training, training in PHCC,
community clinics, rural hospitals, on common transient conditions, knowledge about new
technologies…etc) by percentage ranged between 42.4% and 60.9%
Conclusions:
The faculty must address various parts of current educational program in order to successfully and
efficiently train students for clinical work. This survey can be used as a tool to identify curriculum
trends and the effects of current program revision initiatives in our college of Medicine.

Background: Chronic obstructive pulmonary disease (COPD) is a well-known, preventable, and
curable condition. Frequent respiratory symptoms and a reduction in airflow caused by
abnormalities in the airways and/or alveoli are its defining features (1). The prevalence of COPD is
10 % in people over forty years old whereas COPD prevalence in Iraq among adult smokers is
15.1% (2). Infections are the principal source of acute exacerbation of COPD (AECOPD ( and these
infections are implicated in 40% to 60% of exacerbation cases. Worldwide, a variety of bacteria,
such as Pseudomonas aeruginosa, Streptococcus pneumoniae, Haemophilus influenzae, and
Moraxella catarrhalis, are recognized to cause AECOPD (3).
Aim: The aim of this work was to identify the main bacterial isolates associated with COPD.
Method: This study included 70 patients (46 males and 24 females) suffered from COPD. All
these patients were detected through a full medical examination, and chest examination, such as a
spirometry. Sputum samples were collected and processed, followed by performing gram staining
and culturing. The main isolates were identified using Vitek II systems.
Results: According to results of this study, Pseudomonas aeruginosa was found to be the
predominant cause of COPD infections, with Klebsiella pneumonia following closely in frequency.
Conclusion: In conclusion, Pseudomonas aeruginosa and Klebsiella pneumonia have been
identified as the main bacterial infections associated with COPD.

Introduction: Breast cancer BC is the most common type of malignancy globally and the most
prevalent cancer among women in both developed and developing countries. BC is a related to
higher mortality rate in Iraqi women. BC in Iraq tends to be diagnosed at an advanced stages and
among younger age groups compared to their counterparts in high-income countries.
Objectives: identification of the barriers to early detection of breast cancer among Iraqi women
in Baghdad.
Methods: a cross-sectional descriptive study. Six hundred twenty women were recruited to
participate in the study and a special questionnaire was used to obtain data . SPSS 16.0 version was
used for analyzing data
Results: The mean age of participants was 33.9 ±SD 8.2 and 70.9 % of them were married ,86.4
percent have undergraduate and postgraduate university education. More than forty percent of
studied women have poor knowledge and 53.2% have good knowledge about BC risk factors. The
main barriers are lack of awareness of: the importance of visiting doctor before the appearance of
symptom,about location of clinic,of a specialty to consult first where most of them consult
gynecologist, as well as the long time waiting for consultation.
Conclusion: there were many barriers hinder the early detection of breast cancer .A systemic
health education program about the early detection and screening of BC is required and adding a
new BC early detection units in addition to the established units.

Introduction: Breast Cancer patients in Iraq are often presented younger than those in high
income countries and diagnosed in advanced stages that led to a higher mortality rate. It is due to
absence of screening program.
Objectives:
Publication on the urgent need of Iraq for breast cancer screening is scarce. Therefore this study was
carried out among Iraqi women in southern Iraq.
Methods:
A total of 307 women were selected from (hospitals and PHCCs) in different areas in Dhi-Qar (Al
Gharraf, Al-Dawwaya ,Al-Shattrah and Al-Nassyria) at time of visit. An interview was carried out to
fill the questionnaire, knowledge was scored as poor(0-2), fair(3-5) and good(6-8); score was
used[12],[13]. Variables were expressed by frequency and percentage.
Results:
the age of the participants was 31.44±8.34. age at menarche was 13.08 ± 1.47, the age of marriage for
married women was 23.75 ± 4.03. ( Table 3) show distributed barriers of consulting early detection
center of cancer which were related in person himself, like lack of awareness on visit the doctor only
when the sign and symptoms appear (82.73%), there is no benefit from early detection of breast
cancer (3.25%), lack of knowledge of location of clinics for early detection of cancer. (59.61%),
Lack of knowledge of the priority of the visit when an early examination is desired or symptoms
appear; is to Radiologist (14.33%), or General surgeon (5.86%), or Specialized in screening and early
detection of cancer (37.79%), or Obstetrics & Gynecology specialist (37.45%), laboratory specialist
(4.56%). Other barriers related with socioeconomic conditions shown in (table 4) participants
answered with yes when we asked them is the cost of examination high? Were (14.65%), is the cost
of going to health institution is high? (17.26%), There is no financial possibility to commit to
multiple visits to the cancer early detection center: (33.87%). And in sociocultural barriers Shamed of
the examination: was (28.01%), and the effect of advising some women not to go for the
examination: was (6.19%).. Good knowledge about risk factors that increase probability of breast
cancer was evident among the participants, (55.4%) have score of knowledge (6-8).
Conclusion:
We concluded that there were many different barriers to screening and early detection of breast
cancer, some of them individual specific barriers, and others correlated with socioeconomics
conditions so as to there were barriers include health organization services.

Background: Inflammatory bowel disease affects the colon and small intestine, with Crohn's
disease and ulcerative colitis being the most frequent types. Xanthine oxidoreductase (XOR), a
dehydrogenase enzyme, is expressed in all cells. Its activity is usually modest. During phylogenesis,
the mammalian XOR enzyme regulates ROS and NO production.
Objective:
The objective of this study is to quantify the levels of Xanthine oxidoreductase and investigate any
possible associations between zinc and magnesium in the context of inflammatory bowel disease in
Babylon province.
Materials and Methods:
Xanthine oxidoreductase levels were evaluated in 100 people: 50 with inflammatory bowel disease
and 50 with healthy people. The study participants and the healthy controls varied in age from 15 to
65. The enzyme-linked immunosorbent assay (ELISA) method measured xanthine oxidoreductase
while Iron was in the spectrophotometer in the serum. And used a case-control analysis as study
design.
Ethical Approval
a-Approval of the scientific committee in the Biochemistry Department of Babylon Medical College.
b-Approval of the scientific committee of Marjan Medical City in Hilla city, Babylon province.
c-The objectives and methodology of this study were explained to all participants in the current
research to gain their verbal acceptance.
Results:
The serum xanthine oxidoreductase was greater in IBD patients than in controls (p 0.01). In contrast,
the current study discovered a negative association between zinc and magnesium in IBD patients (p
0.05) and a non-significant relationship between xanthine oxidoreductase, zinc and magnesium in
IBD patients (p > 0.05).
Conclusion:
There is a significant association between IBD and high xanthine oxidoreductase levels in Babylon
province patients.

Background: Rheumatoid arthritis A systemic autoimmune disease causes polyarthritis and
organ damage. Insulin resistance is associated with inflammatory indicators. Glycated hemoglobin
(HbA1c), a biomarker for continuous glucose monitoring, and 1,5-ahydroglucitol are found in the
blood in high but consistent amounts under normal conditions. Disease-modifying anti-rheumatic
drugs raise lipid levels. The aim of study was to evaluate whether or not there is a relationship
between rheumatoid arthritis and diabetes mellitus, using many immunological and biochemical
criteria.
Methods: Current research on rheumatoid arthritis and diabetes mellitus was conducted at Al
Nasriyah Education Hospital with one hundred blood samples collected from patients. Divided into
four groups, this study employed immunological (1,5-anhydroglucitol) and biochemical (random
blood sugar, total triglyceride, and total cholesterol) data.
Result: In the current study, the control group had more 1,5-anhydroglucitol than the patients.
significant increases in random blood sugar, triglyceride, total cholesterol, and HbA1c in patients
with only diabetes and patients with both diseases, as well as a significant difference between
rheumatoid patients and controls.
Conclusion: Patients with type 2 diabetes mellitus who have low 1,5-ahydroglucrtol levels may
be strong predictors of diabetes mellitus. Rheumatoid arthritis patients may have an effect on lipid
profiles, HbA1c percentages, and 1,5-ahydroglucrtol levels, which should be evaluated throughout
the illness.

Background: Acute and chronic hepatitis, both of which can be brought on by the hepatitis C
virus, can range in severity from a mild condition to a devastating, life-long sickness that can
result in liver cancer and cirrhosis. A liver inflammatory disease called hepatitis C. Cytokines
is chemical mediators that control immune cells' development, division, and function.
Evidence suggests that inadequate immune responses contribute to the persistence of HCV.
Objective:
The goal of this study was to immunogenetic of hepatitis C to determine the prevalence of [
hepatitis C virus (HCV Ag) ] among HCV surface antigen-positive (HCV Ag+) persons by
analyzing the association between age and gender and the severity of hepatitis C virus (HCV)
infection, identify and analyze the UTR-polyprotein gene of local Hepatitis C viru
Materials and Methods:
hire 48 individuals From August 2022 to November 2022, a total of persons with acute or
chronic HCV infection were recruited and 5 sample for genetic sequence. Healthy controls
and research participants ranged in age from 21 to 80, and all of them were analyzed using
ELISA RT-PCR and using statistical analysis SPSS and ANOVA.
Results:
48 affirmatives out of 48 Using an ELISA (enzyme-linked immunosorbent test) double
antibody sandwich. we determined that HCV participants met the inclusion criteria. The
findings of the HCV IgM ELISA Kit indicated that the prevalence of HCV was greatest in
those aged 41 to 60 (45.8%), lowest in those aged 21 to 40 (16.7%) and HCV Ag The use of
an ELISA kit enabled the discovery. Of the 48 individuals who tested positive for HCV Ag,
21 (56.2%) were female and 27 (43.8%) were male. This indicates that males are more likely
than females to have HCV Ag infection. And 5 sample in DNA sequencing method was used
to genotype identify and analyze the UTR-polyprotein gene of local Hepatitis C virus isolates
(IQ.No.1 - IQ.No.5) and related Hepatitis C virus genotype isolates from NCBI-Blast.
The local Hepatitis C virus isolates were revealed to be closely linked to NCBI-BLAST
Hepatitis C virus subtype 1a (HQ113638.1) at total genetic alterations (0.3-0.05%), according
to the phylogenetic tree genetic relationship study.
The genetic homology sequence identity between the local isolates of the Hepatitis C virus
(IQ.No. 1 through IQ.No. 5) and the Hepatitis C virus identified by NCBI BLAST ranged
from (99.41% to 99.61%).
The local isolates of the Hepatitis C virus (IQ.No.1 to IQK.No.5) were then submitted to the
NCBI Genbank and given accession numbers (OQ843893, OQ843894, OQ843895,
OQ843896, OQ843897).
Conclusion: TNF levels in patients with chronic HCV were noticeably higher than
average, New strains of the virus in the gene bank, and therefore we did not find any Iraqi
strains registered can compare with them

Background: Etiological studies have identified several modifiable and non-modifiable risk factors
that have a role in developing colorectal cancer.
Aim of the Study: This study aimed to assess the risk factors of colorectal carcinoma in Hiwa
Hospital in Sulaimani City / Iraq.
Methods: A case-control study design was used to conduct the present study. From November 2021
to May 2022, 300 participants were included in the present study. Data were analyzed using the
statistical package for the social sciences version 25.0. A P-value ≤ 0.05 is considered a significant
value.
Results: Patients mean age ± SD was 55.8 ± 16.14 years (ranging from 22 – 91), and the controls
mean ± SD age was 52.17 ± 13.9 years (ranging from 20 to 87 years). (50%) of cases had a family
history of colorectal cancer. Logistic regression analysis revealed that there are positive statistically
significant associations between colorectal cancer and having a family history of colorectal cancer,
obesity, being overweight, living in urban areas, eating raw red meat, did not eat fruits and vegetables,
drinking canned juice, sugar-sweetened juice, and carbonated beverages, and illiteracy (P < 0.05).
Conclusions: The was a positive association between colorectal cancer and having a family history
of colorectal cancer, obesity, being overweight, eating raw red meat, drinking canned juice, sugar-
sweetened juice, and carbonated beverages, living in an urban, did not eat fruits and vegetables, and
illiteracy.

Diagnostic and prognostic biomarkers for prostate cancer are few. It has been discovered that it
is clinically challenging to discriminate between aggressive and non-aggressive prostate cancer.
The aim of this study is to examine the hypothesis that Sox7 may be used as a potential
biomarker for prostate cancer diagnosis and prognosis. Sox7 is a transcription factor that is
found to play a role in controlling different biological processes throughout embryonic
development, such as hemopoiesis, vasculogenesis, and cardiogenesis. It is also believed to be a
tumor suppressor in a number of malignancies. Its function in prostate cancer, however, is not
well understood. Nuclear and cytoplasmic Sox7 expression has been evaluated by
immunohistochemistry using normal (16) and malignant (80) prostate tissues. The
immunohistochemical study showed reduced nuclear and cytoplasmic Sox7 expression in
prostate cancer compared to normal prostate tissues. This reduction was also associated
significantly with increased primary Gleason grade. This data suggests the possibility that Sox7
may play a key role in prostate tumor formation or aggressiveness, highlighting the need for
further study to clarify its role and establish whether it might be used as a prognostic biomarker
for prostate cancer.

The five lumber vertebrae are a part of vertebral column and illustrated from vertebrae in
further sections by their large size. Lumbar disc prolapses ('slipped disc') accounts for less than
5% of all low back problems, but is the most common cause of nerve root pain ('sciatica'). Ninety
percent of acute attacks of sciatica settle with conservative management. Quasi experimental
pretest posttest design study conducted among 100 patients with sciatic pain and low back pain
during the period of 13 December 2021 to 1 September 2022 to evaluate the effectiveness of
physiotherapy on reducing numbness and paresthesia of lower limb among patients with lumber
disc prolapse at Rania District. The data of the study, collected by utilized constructed
questionnaire form, which composed of the two parts; first part included questions about the
sociodemographic characteristics of the study sample, while second part consist of presenting
(back pain and sciatic pain before starting physiotherapy and the percentage of remaining these
complains after finishing sessions of physiotherapy). The data of the study collected in Rania city
among 100 patients by using constructed questionnaire, interview technique (face to face method)
with the study sample. Data were analyzed by using SPSS V21 software program to produce
descriptive analysis such as (percentage and frequency). For the current study data were collected
from 100 patients that suffered from Lumber 4 and Lumber 5 disc prolapse, age of the majority of
patients between 50 to 69 years old. And female more than male, most of them were obese, and
presenting chronic back pain. Only a few number of the study sample had history of
laminectomy. Most of the study sample were free from back pain, while all of the samples had
sciatic pain before physiotherapy, and after physiotherapy the range of back pain decreased and
regarding sciatic pain dramatically reduced among the majority of participants.

Background: Extremity arterial injury after penetrating trauma is common in military conflict
or urban trauma centers. Most peripheral arterial injuries occur in the femoral and popliteal
vessels of lower extremity. Physical examination identifies the majority of vascular injuries and
findings are classified either hard signs or soft signs of vascular injury. In general, hard signs
constitute indications for operative exploration, whereas soft signs are indications for further
testing or observation. Surgical exploration with end to end anastomosis or saphenous vein graft
are effective methods in restoring blood flow and limb viability status.
Aim of study: Analysis of 100 cases of penetrating femoral artery injury and determination of
ag, gender, mode of presentation, surgical procedures and limb salvage after revascularization.
Patients and Methods: This is a retrospective study on 100 patients had been admitted to the
emergency department in Al-Hussain teaching hospital in Thi-qar governorate in Iraq over a
period of 7 years from January 2013 to January 2020. All the patients were victims of penetrating
injury to the thigh, patients’ data were collected from hospital records including age, gender,
mode of presentation of vascular injury regarding limb perfusion, preoperative investigations,
most common part injured from femoral artery and surgical procedures used for revascularization.
Results:
We reviewed 100 cases of femoral artery injury, 90 patients ( 90%) were males and 10 patients (
10%) females with mean age 33 years .Most commonly superficial femoral artery (SFA) were
involved in 78% , common femoral artery 13%, profunda femoris ( deep femoral artery ) in 9%.
Pulse deficit and limb ischemia were the most common clinical findings in seventy five patients
(78%), twenty two patients with soft signs (22%) from them (10% with proximity of injury to the
major vessels, 8% with hematoma, 4 % with nerve injury). Preoperative imaging were performed
in only 22 patients 22%) with subtle clinical findings i.e soft signs while patients with hard signs
of limb ischemia (78%) admitted directly to the operative theatre. End to end anastomosis were
performed in 55% , reversed saphenous vein graft in 36% , ligation in only 9 patients (9%) with
profunda artery injury, no primary amputation was performed. Limb salvage rate were 98% while
secondary amputation was done in only 2 patients due to advanced ischemia during presentation
aggravated by long delay between time of injury and surgery.
Conclusions:
There is high rate of limb salvage after femoral artery injury whatever the type of surgical re
vascularization chosen. Pre- operative imaging is unnecessary
if there were hard signs for
vascular injury.

Clinical biochemistry is a scientific discipline within the larger field of medicine, which integrates
knowledge gained from fundamental and applied research for understanding the biochemical and
physiological processes of humans and application of the resulting knowledge to the diagnosis,
treatment, and prevention of disease. There are many laboratory tests available for clinicians to obtain
useful information related to diagnosis and treatment; however, if these tests are conducted
inappropriately, they are at best useless and at worst misleading and dangerous. most laboratory errors
occur in the pre-analytical phase. the aim of the present study was to investigate the state of
knowledge of clinical biochemistry among a group of Iraqi doctors in Basra province with particular
emphasis on the rate of pre-analytical phase errors related to ordering, collection, and sample
handling.