Annals of the College of Medicine Mosul

Aim: To evaluate the prevalence of over and under weight in children aged 6-14 years in
Mosul city and to observe the important risk factors.
Methods: A cross-sectional study of four governmental primary schools in Mosul city with a
total of 2056 child aged 6-14 years were included. Analysis of the data was done by using
SPSS and excel computer systems, X2 test was used for statistical analysis.
Results: The study reveals that the prevalence of under weight is 6.8%; on the other hand
the prevalence of over weight and obesity were 11.3% and 9.8% respectively. Also the study
shows that about three quarters of over weight and obese students spend three or more
hours daily in watching television, and (44.2%) of them eat more than three meals per day.
Conclusions: Overweight and obesity are prevalent problems in Mosul, it is valuable to
conduct a study to evaluate the risk factors

Objective: To check the value of ultrasonography in the diagnosis of undisplaced partial
forearm fractures in children.
Methods: A case series study was conducted in AL-Khansa\\'a and Al-Zahrawy teaching
hospitals in Mosul over a period between November 2005 to October 2006. One hundred
patients (54 male and 46 female) between the age of 2-15 years suffering from high clinical
suspicion of non displaced forearm fractures were first examined by ultrasound (Sonoline SL
100, Siemens Nurnberg Germany) with 7.5MHZ linear array transducer by a radiologist who
gave an immediate report. Standard two views radiography of the forearm then obtained. The
radiographs were reported by another senior radiologist. Ultrasonographic and radiographic
reports were then compared.
Results: One hundred patients were examined, 54 male and 46 female with male/female ratio
1:1.7. The type of fractures found were 46 torus type, 48 greenstick and 6 were plastic
deformity. Subperiosteal haematoma was encountered in 100% of the fractures, bending sign
was 100% and finally reverberation echoes was shown in all the fracture types too.
Conclusion: Ultrasound is a useful method in the diagnosis of undisplaced forearm fractures
in children. It is an easy, safe , fast and in-expensive procedure. More studies are indicated to
confirm its reliability in different pediatric fractures.

Objective: To evaluate results of treating laryngeal cancer by total laryngectomy.
Methods: A prospective study of 36 patients with squamous cell carcinoma of the larynx
treated with total laryngectomy over five years period.
Results: The age range of the patients was between 34-72 years with a male to female ratio
of 11/1. After five years follow up of patients , 100%, 84% & 14% were free of disease for T2,
T3 & T4 respectively. Results of treating cases at T3 stage seems to be better when surgery
preceded radiotherapy than when radiation given before.
Conclusion: Combination of surgery and radiotherapy gives relatively high cure rates if
stage of tumour was still within the larynx ( T3 or less). The results of this study shows that
this was better when surgery preceded radiotherapy.

Objective: To demonstrate that isolated renal hydatid cysts have heterogeneous
presentations.
Methods: a retrospective case series study during the period from Jan 2002 to Jan 2007 in
the urosurgical department at Al-Jamhory teaching hospital. Five patients with different
preoperative diagnoses were dealt with. After their initial clinical assessment and investigating
their pathology by lab and imaging studies including IVU and MRI, provisional diagnoses were
put and they were explored through lumbar approach and the pathology dealt with
accordingly.
Results: there were three females and two males with six isolated renal hydatid cysts; mean
age 28.8 years. Five cysts involving the left kidney. Their initial diagnoses were pyonephrosis,
renal tumor, paracolic abscess, uremia due to large bilateral renal cysts and lower moiety
hydronephrosis in a duplicated system. The preoperative diagnosis of renal hydatid was
certain in two patients (40%) after cyst aspiration and hydatidiuria; the other three cases were
diagnosed intraoperatively, and all cases proved by histopathology. Passing daughter cysts
with the stool in a left side renal pathology may help in the diagnosis of a complicated renal
hydatid cyst.
Conclusion: isolated renal hydatid is a rare disease, has heterogeneous presentations, and
preoperative diagnosis may not exceeds 50%, so it needs to be kept in mind in the differential
diagnosis of renal space occupying lesion.

Objective: To demonstrate the mucin changes in Ulcerative Colitis, to evaluate the benefit of
the staining method and to demonstrate the CEA staining pattern in dysplasia complicating
ulcerative colitis (U.C).
Methods: Colorectal biopsies were examined for changes of U.C for which a combined
PAS/Alcian blue stain was applied. CEA immunohistochemical stain was used for cases of
dysplasia complicating ulcerative colitis.
Results: One hundred colorectal biopsies were examined, U.C. was diagnosed in (22%) of
cases, the mean age was (36.68) years, (13) were males, and (9) were females. The
prevalence of dysplastic changes complicating U.C were detected in (22.7%).The rectum was
the most frequent site of dysplasia complicating, U.C.. Two of the cases showed mild
dysplastic changes; two showed moderate dysplasia, and only one showed severe dysplasia.
The secretory activity of mucin in colorectal mucosa was tow in surface epithelium and varied
in the crypts from absent or weak to moderate reduction.
The site of CEA distribution seemed to be affected mainly by degree of dysplasia, it was
predominantly along the apical surface of the cells and also in the cytoplasm in case of mild
dysplasia, while in moderate dysplasia it was of cytoplasmic distribution, and in severe
dysplasia there was intensive cytoplasmic distribution.
Conclusion: There was an increase in relative frequency of U.C.
Immunohistochemical study of CEA localization in dysplastic gland is helpful in detection of
early malignant change in U.C.

laser (LLLT) and conventional treatment (triamcinolone acetonide kenalog) and select the most
effective and faster method for treatment by assessing clinically the effect of these two methods on
healing process of recurrent aphthous ulceration.
Subjects, materials and methods: A prospective study of 34 patients, age range 11-45 years, with
RAU lesions were divided into: Control group: RAU patients without any treatment.
Group I: RAU irradiated with 1.5 Joule laser into two doses (in alternative day).Group II: RAU given
triamcinolone acetonide kenalog in orabase daily in two doses. The results obtained account for
duration of lesions, size measurement, pain symptoms, and presence of erythema in three visits.
Results: Clinically the mean duration of ulcers healing did not differ widely from control group. The
pain sensation of RAU that was treated decreased. Statistically, there is no significant difference in
the healing process of RAU treated by LLLT and treated by triamcinolone acetonide kenalog.
Conclusion: low level laser therapy is biomodulation (biostimulation and bioinhibition).Topical
triamcinolone is a glucorticoid that has anti-inflammatory and anti proliferative effects. Clinically they
slightly decreased the normal time of healing of this immune dysregulating lesion, but there is no
superior difference in clinical effects between these two methods.

Aims: To assess the quality of life (Q.o.L) of amputee patients and the relation with some
variables.
Methodology: A descriptive study was carried out at Al-Mosul rehabilitation center during the
period from 10th April to 30th June 2004. The sample of the study consisted of 160 amputee
patients with lower limb amputation selected randomly. The data was collected by using
assessment tool which consists of (66) items distributed to three domains (physical,
psychological and social).
Results: The results of the study show that there are many problems in all areas through the
amputee patient\'s life. The psychological problems come in the first rank among problems
faced by amputee patients, while the physical and social aspects come later throughout the
amputee patient life . Significant differences were found between the quality of life of amputee
patient and variables of study (age, social status, level of education, urbanicity, level of
amputation, reason of amputation and using assistance device).
Recommendations: The study recommended to establish rehabilitation centers to
accommodate war victims; training program should be carried out in special workshop for
vocational rehabilitation therapy and educational programs for families of amputee patients for
care to provide and improve quality of their life.

Objective: To assess the prevalence of anticardiolipin (ACL) and antiphosphatidylserine
(APS) antibodies in women with repeated abortion in Mosul region.
Methods: Women with history of three or more recurrent spontaneous abortions in their first
trimester were studied, for ACL and APS antibodies in their sera by enzyme linked
immunosorbent (ELISA). Fifty normal pregnant women during the first trimester were included
as a control. Chi –squared test was utilized for evaluation.
Results: One hundred –sixty women were tested. ACL and APS were detected in 45/160
(28%) & 22/160 (13.7%) respectively. These antibodies were negative in all control
group.
Conclusion: Positivisty of ACL antibodies among women with recurrent spontaneous
abortion is a common finding in Mosul region. The use of low dose aspirin plus heparin in
management of such women had successful result.

Objectives: Determination of the degree of lead exposure and to study the possible effects of
lead on different haematological parameters.
Methods: A haematological study of thirty battery repair workers and thirty-four blood donors
(as a control) in the period of 2 months (January – February 1998). All the workers and the
donors were subjected to a clinical and laboratory evaluation. The laboratory tests included
complete blood picture, blood lead level determination and iron status study.
Results: Analysis of lead in the blood showed that the mean blood lead level (BLL) of these
workers was significantly higher than that of the control (P< 0.001). 20% of the battery
repairers had symptoms, while 16.7% of them had normochromic normocytic anaemia and
23.3% had reticulocytosis. Iron status was normal in all of the repairers but it was found that
transferrin saturation of the repairers with BLL of more than 70 µg/dl RBC was significantly
higher (P< 0.05) than those repairers with BLL of or less than 70 µg/dl RBC.
Conclusion: Battery repairing is an important new source of lead exposure in our community
and periodic medical supervision is required as well as improvement of their working
conditions.

Objective: Intestinal amebiasis is still an important health problem in developing countries of
the world. One of the issues for future biomedical research is the development of
antimicrobial resistance, and the search for alternative new antiamoebic drugs. A study was
carried out to evaluate the efficacy of albendazole on the viability of Entamoeba histolytica
clinical isolate from human which was used for experimental animals.
Materials and Methods: All experimental animal models (18 albino mice and 18 rabbits),
were divided into 6 groups, each group with either 6 mice or 6 rabbits, were orally infected
with E. histolytica (clinical isolate), then after 7 days they were given drugs (Metronidazole or
Albendazole) daily according to body weight prepared in advance for 5 days duration and in
addition to the controls without drugs. Stool specimens of each group were examined
microspically for viable trophozoites, and the number of these trophozoites were counted with
haemocytometer chamber, as compared to untreated and treated groups. Statistical analysis
was done by using Student‘s- t-test.
Results: The results showed infection of E. histolytica initiated in rabbits only. Albendazole
and metronidazole were highly effective (100%) for the treatment of infected groups of
rabbits. Trphozoites of E. histolytica were highly sensitive to albendazole (25% viability), and
metronidazole (22.7% viability) at a dose of 400 mg / kg / day and 250 mg / kg / day,
respectively, which was significant in relation to the control (500% viability).
Conclusions: The present study showed that the newly used albendazole is very effective
anti-amebic drug as metronidazole in rabbits.

Aims: To compare the level of serum uric acid (UA) in type 2 diabetics with a control group
and to demonstrate its relation with other risk factors as age , BMI, duration of diabetes, blood
glucose and total cholesterol level.
Methods: The study was conducted in Al-Wafa Diabetic Clinic in Mosul during the period
from February to May 2007 as a case-control study. A 39 patients of both sexes with type 2
diabetes with a mean ± SD age of 51.5± 11.1 years , and 20 healthy subjects of both sexes
with a mean ± SD age of 46.5±15.5 years as a control group. The concentrations of fasting
serum glucose, total cholesterol and UA was determined; BMI was calculated.
Results: BMI, fasting serum glucose, UA and total cholesterol concentrations are significantly
higher (P < 0.001, 0.01 , 0.01 respectively) in type 2 diabetics compared to the control group
with a positive correlation ( r = 0.605 , P < 0.005 ) between serum UA and the duration of
diabetes.
Conclusions: Because serum UA concentration is significantly higher in type 2 diabetics
independent on other factors and as it predicts the occurrence of ischemic heart diseases,
stroke and even renal disease in these patients; therefore, its measurement is recommended.
Since it positively correlated with the duration of diabetes, therefore, the longer the history of
diabetes was, the more frequent measurement should be done.

Objective: To compare the number of cataract surgery rate in Mosul to other part of the world
and determine the factors that influence this rate.
Methods: case series study from public and private hospitals in Mosul, on patients who had
cataract operations during 2001.
Results: Cataract surgery rate was 1098 per 1 million. Only 15.2% were associated with
intraocular lens implant.
Conclusion: Cataract surgery rate in Mosul was the same as in other Middle East Countries,
but was very low compared to developed countries.