Medical Journal of Babylon

Eating and drinking are essential for life. There are clinical situations that
artificial hydration is necessary. For dying patients artificial hydration looks useless
and in many conditions could even be harmful (e.g. pulmonary edema in
hypoalbuminemic patients). In our medical culture artificial hydration is a symbol of
care to the patient and withholding it, is a very emotive issue, especially to the family.
Attention to autonomy, explanation about advantages and disadvantages of artificial
hydration to the family and reassure them that the patient will be looked after and
kept comfortable till the last seconds might be the solution of this ethical dilemma.

This study was carried out on 52 subject of Babylon dentistry student and children who were naturally infected with measles virus and laboratory confirmed as measles during 2009 by detection of specific anti-measles IgM .They were tested for IgG avidity to estimate their immune status and to distinguish between primary measles infection and reinfection due to secondary vaccine failure. The study reflected that all unvaccinated subjects (19.2%) showed a primary immune response whereas secondary immune responses were detected in( 46.09%). Of 34 subjects sourly vaccinated (42.9 %) of them reflected a primary immune response, whereas (57.1%) of them reflected secondary immune response ,thereby indicating a secondary vaccine failure that was seen at very high proportion in subjects > 11 years old, so that revaccination of 11 years old children is recommended for reactivation of their immune status to restrict secondary reinfection.

The aim of this work was to evaluate the efficacy of adding prednisolone to clomiphene citrate (CC) in
CC-resistant polycystic ovary syndrome (PCOS) in induction of ovulation.
Methods: forty three infertile women with CC resistant PCOS were randomly assigned into two
groups. Group I (31 patients 72.09%): Clomiphene citrate 100 mg/day was given from day 2 to day 6
of the cycle and prednisolone 10 mg/day from day 2 to day 12 of the cycle. Group II (12 patients
27.9%): CC 150 mg/day was given from day 2 to day 6 of the cycle. The main outcome was ovulation.
Secondary measures included endometrial thickness and pregnancy rate. Ovarian follicular response
was monitored by transvaginal ultrasound.
HCG 10 000 U was given when at least one follicle measured 18 mm, and timed intercourse was
advised.
Results: There were no statistically significant differences between groups regarding the age, duration
of infertility, menstrual pattern, hirsutism, and PCO features by U/S. the mean endometrial thickness
were significantly higher in the 1st group than in the 2nd group (P < 0.05). Similarly, there were
significantly higher rates of ovulation (74.19 versus 16.66%) (P < 0.001) and pregnancy rate (54.84%
versus 8.33%) (P < 0.05). Prednisolone was very well tolerated as no patients complained of any side
effect.
Conclusion: Induction of ovulation by adding prednisolone to CC in CC-resistant PCOS is associated
with no adverse anti-estrogenic effect on the endometrium and higher ovulation and pregnancy rates in
a significant number of patients.

Background: The roles of group C and F streptococci in causing endemic pharyngitis are still
controversial, although group C streptococci are implicated in the outbreaks of pharyngitis and
associated disorders.
Aim: The aim of this study was to determine the prevalence and the role of these groups of β-
hemolytic streptococci in acute pharyngitis with emphasis on Streptococcus anginosus group. The
antimicrobial susceptibility profile of these bacterial isolates and their ability to produce some
virulence factors was also be determined.
Materials and Methods: Throat swab specimens were collected from 177 patients suffering from
acute pharyngitis who had been admitted to Hilla teaching hospital (Hilla, Iraq) during October 2009 to
January 2010. The necessary biochemical tests were conducted and the organisms identified using
standard procedures. Susceptibility of isolates pathogens to several antibiotics was examined using
standard susceptibility testing. Virulence factors of theses isolates were also determined using standard
methods. Results: Results revealed that a total of 67 isolates were belonged to β-hemolytic
streptococci. Of which, 11(16.4%) isolates belonged to anginosus group streptococci, which possess
Lancefield group C and F antigens. Most of these bacterial isolates have the ability to produce more
than one virulence factor such as capsule, hemolysin, CFA III, and lipase enzyme. The bacterial
isolates were highly resistant to ampicillin, cefotaxime , and cefepime while they exhibited moderate
resistance to tetracycline, ceftriaxone, and ciprofloxacin, On the other hand they showed high
sensitivity to vancomycin, ofloxacin, and clindamycin.
Conclusion: This study concluded that group C and F Streptococci were implicated as a cause of acute
pharyngitis in 6.2% of the specimens among other groups of streptococci. Most of these isolates have
the ability to produce more than one virulence factor and there was a high rate of resistance among
isolates for β-lactam antibiotics, but they were highly susceptible to vancomycin, ofloxacin, and
clindamycin..

We are here reporting a case of an incidental finding of the thyroidea ima artery emerging from the
brachiocephalic trunk with a typical inferior thyroid vessels on both sides emerging from the
thyrocervical trunk. The thyroidea ima artery entered the thyroid gland near to right side of the isthmus
from the lower border approximately 1 cm below the normal inferior thyroid.
It arose from the brachiocephalic artery proximal to its bifurcation. It ran deep to the infrahyoid
muscles, giving off a branch that run downward to the superior mediastinum, and then supplying the
anterior surface of the isthmus and the right lobe of the thyroid gland by means of two branches.

A case of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D) has been
presented . ARVC/D is a disorder of RV myocardium which involves replacement of the myocardium
with fibrofatty tissue. The diagnosis was based on the findings of enlarged RV by echocardiography,
ECG findings of: a) TWI (T- wave inversion)in V1,V2 & V3. b)Epsilon wave in V1,V2, and more
than 500 VEs/24 hour by Holter monitoring .Positive family history of sudden death in first degree
relative (mother) was found.
This case supports the first report of 34 Cases of ARVC/D reported in Iraq and attracts the attention of
the physicians, echocardiographers and cardiologist to the diagnosis of this fatal disorder where
SCD(sudden cardiac death) can be prevented by ICD(implantable cardiac difebrelattor) implantation.

Background: Pityriasis versicolor, one of the most common disorders of pigmentation. It is a
cutaneous superficial fungal infection characterized by pigmentary changes due to colonization of
stratum corneum by dimorphic lipophilic yeast; Malassezia furfur. In general, pityriasis versicolor is
thought to cause hypopigmented lesions in individuals with dark skin and hyperpigmented lesions in
those with white skin.
Objective: It is a descriptive study to know the pigmentary variation of tinea versicolor in Al-Muthana
Government.
Patients and Methods: This study was based on a sample size of 100 patients of pityriasis versicolor
who attended the department of Dermatology and Venereology at Al-Samawa general hospital in the
periods from January 2009 to March 2010. Diagnosis of tinea versicolor was established by 10% KOH
examination of scraping from skin lesion and wood's lamp examination for the golden yellow
fluorescence of skin lesions.
Result: From 100 patients with pityriasis versicolor, There were 64 males and 36 females. The age of
patients ranged from 5-65 years with a mean age of 24.25 ± 3.22 years. Majority of cases (41%)
occurred in the age group of 21-30 years. Sixty sex (66%) of cases had hyperpigmented macular
lesions followed by hypopigmented type (23 %), combination of both; hyperpigmentation and
hypopigmentation (6 %) and erythematous type (5 %) of lesions. The predominant site of the disease
was trunk especially the upper trunk involves in 79 cases, followed by neck in 45 cases, upper limb in
34 cases face in 28 cases and lower limb in 11 cases.
Conclusion: all types of pigmentary variations in pityriasis versicolor are present in Al-Muthana's
patients with a predominance of hyperpigmented ones.

Abstract
This is a prospective study that was carried out on 50 patients at the central teaching hospital for
children in Baghdad, 20 males and 30 females. Their age ranged from 1-60 days with body weight
ranged from 1.8-3.5 Kg., eight patients were premature.
The study revealed atresia in 15 (30%) cases, stenosis in 12 (24%) cases, malrotation in 10 (20%)
cases, and annular pancreas in 7 (14%) cases. prenatal ultrasound diagnosed 3 patients. Bilious
vomiting was the commonest presenting symptom (42 patients (84%)), associated congenital
anomalies were found in 18 (36%) patients. Down syndrome was found in 10 (20%) patients, maternal
polyhydramnios was observed in 20 (40%) patients and in one patient there was a family history of
previous anomalies. Low birth weight and prematurity significantly affect the outcome, associated
anomalies account for most of the morbidity and mortality and early diagnosis result in better outcome.
Objectives (aim of study)
To study cases with congenital anomalies of duodenum and verify the causes, clinical presentation,
diagnosis and outcome in infants admitted to the central teaching hospital for children in Baghdad.

Background and purpose: Cigarette smokers have a higher risk of developing several chronic disorders.
These include several types of cancer, chronic obstructive pulmonary disease and atherosclerosis which is a
chief contributor to the high number of deaths from smoking. Cigarette smoking potentiates the harmful
effects of total cholesterol and reduces the cardio-protective properties of high density lipoprotein
cholesterol (HDLc), increasing the risk of coronary heart disease(CHD). Decreased serum HDLc is one of
the most common lipid disorders in patients with CHD. Existing evidence suggests that every 1 mg/dl
decrease in serum HDLc increases the risk of CHD by 2-3%.
HDLc levels are known to be lower in smokers than in nonsmokers. However most studies have not
been mentioned whether heavy or light smoking affect HDLc level. The aim of the present study was to
evaluate the effect of light and heavy smoking on HDLc level.
Material and method: Sixty apparently healthy participants were included in the study, twenty subjects as
control group, twenty light smokers(those who smoke less than ten cigarettes per a day) and twenty heavy
smokers (those who smoke ten cigarettes and more per a day).Their mean age ± SD was
35.25±4.38,37.25±4.74,37±3.93 for control, light smokers and heavy smokers groups respectively .The
mean of the BMI of the same groups was 23.36±1.7,22.91±1.67 and 23±1.49.HDL-C was measured by
colorimetric method.
Results: The mean values of HDLc of control ,light smokers and heavy smokers was 1.43±0.42 mmol/l,
0.75±0.17 mmol/l. and 0.6±0.2 mmol/l groups respectively .There was significant differences in the mean
level of HDLc between control group and light smoker and heavy smoker groups(P< 0.05).However the
mean value of HDLc of light smokers was not significantly different from the mean level of heavy
smokers(P>0.05).
Conclusion: Smoking whether light or heavy equally affect HDLc level by deceasing its concentration in
the serum and hence increase the risk of CHD.

In this clinical trail, a 42 patients (12 males and 30 females) of 12- 32 years old were randomly
selected. They were clinicaly diagnosed as common warts on at least two symmetrical limbs (upper or
lower) were selected and counted to form two groups of right sided and left sided warts. Each side of
patient treated with methotrexate (MTX) intralesionally or electrocutary of his /her warts. Both
treatment types were randomly allocated to either right side or left side warts. The mean No. of warts
was 4.52 on upper limbs and 3.9 on lower limbs. A 6.78% of these warts wich was treated with
intralesional MTX were cleared compared with 22.6% for electrotherapy. We found that MTX to have
clearance rate less than electrocutary. In conclusion: intralesional MTX is less effective than
electrocutary in treating common warts on hands and feet.

237 patients with hyperthyroidism age range (between 20->60) years attended to nuclear medicine and
radiotherapy hospital in Mosul during the period 2001-2003 treated by radioactive iodine 131and followed
for one year shows completely relieve from their symptoms after giving them suitable doses of radioactive
iodine 131 .The study sample showed that age group between (40-49) years was more affected than others
in a percentage of (28.7%). Also the study discovered that females were more affected than males in a
percentage of (62%) and (38%) respectively. Our study showed that the main cause of thyrotoxicosis was
diffuse hyperthyroidism (46.4%), and the most appropriate given doses needed was (5-10)mc I131 which
was about 37.1%. Finally our study revealed that radioactive iodine 131 therapy for hyperthyroidism was
simple, Cheap and non invasive method of treatment .

Back ground : This study evaluated the ability of exercise induced ST segment elevation in aVR in
patients with Duke treadmill score £ -11 to predict left main stem disease and three vessel disease and
to investigate the ability of ST segment elevation in aVR more than 2 mm to differentiate between left
main stem and three vessel disease.
Methods :66 patients with Duke score £ -11 were divided into three groups. group 1 included 16
patients with no ST elevation in aVR, group 2 included 21 patients with ST elevation less than 2 mm
and group 3 included 29 patients with ST elevation more than 2 mm, coronary angiography was done
and results were correlated with ST elevation in aVR
Results : 70% of patients with ST segment elevation in aVR had either left main stem or 3 vessel
disease. Exercise induced ST elevation in aVR had sensitivity of 95% and specificity of 32% in
predicting left main disease, while exercise induced ST elevation in aVR more than 2 mm had
sensitivity of 89% and specificity 74% in predicting left main disease.
Conclusion : Eercise induced ST segment elevation in aVR in patients with Duke score £-11 is
sensitive but not specific for both left main and three vessel disease while ST segment elevation in
aVR of more than 2 mm is both sensitive and specific for left main but not for three vessel disease

The aim of this study to held a comparasim between FNAC and histopathology of patient with nodular
goiter.
Methods:- A prospective study of seventy eight patients included through the period between may
2009- October 2009 .All cases presented with multinodular and diffuse goiter, Ultra sound and thyroid
function test were done for all them. The aspirated contents of the needle are expelled on to glass
slides . two slides were immediately fixed in 95% ethyl alcohol for about 30 minutes and the slides
well stained with Haematoxylin and Eosin (HandE).
Results :- The types of thyroid nodule cases which is diagnosed by FNAC are predominant of
nodular colloid goiter 52 (66.6%) cases, followed by hyperplastic thyroid nodules 6(7.6%) cases, the
thyroid cyst and papillary carcinoma having 4(5.1%) cases, , and finally the follicular tumor and
hashiomato's thyroiditis 3(5.1%).
the histopathology results are reveal the nodular colloid goiter is the most common disease 61(78%)
cases, hyperplastic thyroid nodule is the second common one, followed by Hashiomato's thyroiditis
and follicular adenoma 4(5.1%)cases. the papillary carcinoma represent the last one 2(2.5%) cases.
There are three false positive cases and one false negative case. The sensitivity (80%) , specificity
(96%) and accuracy (97%) .
Conclusion:-FNA cytology of thyroid goiter are sensitive, specific, accurate and should be done
before surgery to decide type of surgery patients needs.

Background: Oxidative stress has been implicated as important cause of Methotrexate (MTX)
induced liver toxicity. Recently nebivolol and aliskiren have been described to posses antioxidant
properties.
Objective: This study was designed to investigate the hepatoprotective potentials of Nebivolol and
Aliskiren on MTX induced hepatotoxicity.
Materials and methods: A total of 32 rabbits were randomized into 4 equal groups. Group 1 received
no treatment (control) while group 2,3 and 4 received MTX, MTX+Nebivolol or MTX+Aliskiren
respectively for 8 weeks. At the end of 8th week all animals were sacrificed and liver function tests
(SGOT, SGPT, ALP, bilirubin, TSP and PT) were measured. Liver tissues were used for
measurement of MDA and GSH levels and for histopathological evaluation.
Results: MTX treatment caused significant impairment in liver function profile. MTX also induced
significant increase in MDA and significant decrease in GSH levels in liver tissues. Nebivolol and
aliskiren significantly improved liver function profile. Both drugs also reduced MDA levels and
elevated GSH levels. Furthermore hisological evaluation of liver sections confirmed the hepatotoxicity
of MTX and the improvement with the combination treatment of nebivolol or aliskiren. These findings
suggested that both drugs have promising hepatoprotective potential against MTX induced liver
toxicity.

Background: After an acute myocardial infarction, Leukocytosis and increase
neutrophils to lymphocytes ratio (NLR) may be associated with increased risk of inhospital
heart failure, and death.
Objectives: To evaluate the role of total WBC count and NLR as an in-hospital
predictor for adverse events (death and heart failure) for the patients presented with
acute MI.
Methods: A total of 98 patients who had no history of heart failure presented with
acute myocardial infarction were studied in Marjan Teaching Hospital along their
hospitalization period (i.e. for one week) by measuring total WBC count and NLR for
each patient; Echocardiography and chest x-rays were done for patients to determine
whom developed heart failure, any death occured during hospitalization had been also
documented.
Results: Patients were divided into 3 groups according to a cut lines (mean & 80
centile), (1st centile = 48 patients, 2nd centile = 29 patients, 3rd centile = 19 patients).
Most patients with high baseline WBC count were associated with the development of
heart failure (p value <0.05) and increase in-hospital mortality (p value <0.05).
Regarding the NLR it showed that higher ratio was associated with the development
of heart failure (P value < 0.05), and with increasing mortality.
WBC count and NLR were independent predictors of in-hospital death after
application of the Binary Regression Analysis.
Conclusion:
1- WBC count and NLR are predictors of adverse in-hospital outcome (heart failure
and death) after acute myocardial infarction.
2- Both WBC count and differential ratio (NLR) are independently acting as
predictors for in-hospital mortality.

Metabolic syndrome(MS) is becoming a serious global problem .This study was carried out on patients
with type 2 diabetes mellitus attending Merjan teaching hospital, diabetic clinic in Babylon city, for
the period from December 2009 to March 2010 ,to investigate the occurrence of metabolic syndrome
among diabetic patients .The relevant data were collected ,anthropometric measurement and laboratory
estimation of triglyceride and high density lipoprotein-cholesterol(HDL-C) . The study was conformed
on 200 diabetic patients ( 90 males,110 females) the mean age group was 59.2±9.2 for males and 56.5
±9.02 years old for females. Metabolic syndrome was diagnosed according to the criteria of National
Cholesterol Education Programme(NCEP) in 133 patients(59 males and 74 females). The prevalence of
metabolic syndrome among diabetic patients was 66.5%.MS was distributed in 65% urban and 35%
rural area. In MS patients. The mean waist circumference in males was114±1.15Cm.and
107.8±12.9Cm in females. Mean triglyceride level in MS patients was 2.74mmol/l±0.38 in males and
2.4mml/l ±0.5 in female Mean level of high density lipoprotein was 0.83mmol/l±0.08 in males and
0.9mmol/l±0.14in females. Body mass index was 31.19 in MS patients. most patients with MS have
three components mainly Diabetes and hypertension and one of these disorders (obesity as measured
by BMI and waist circumference ,hypertriglycerdemia and decrease in HDL-C.

Background: Management of 3rd stage of labour with its unpredictable life threaten complication has
been debated for centuries and still arouses much discussion.
There is some evidence that cord drainage of placental blood may reduce the duration of 3rd stage of
labour and the need for manual removal of placenta.
Aim of the study: To evaluate the effectiveness of placental blood drainage via the umbilical cord in
reducing the duration and blood loss in 3rd stage of labour and the incidence of PPH.
Method: A prospective study involving 200 women having vaginal delivery were divided into
drainage group(100 women) and control group (100 women) .
The main outcome measures were duration of 3rd stage and amount of blood loss .
Result: The mean duration of 3rd stage was ( 5.35+2.3 minutes ) in the study group and ( 8.9+4.9
minutes ) in control group. The average blood loss was ( 184.3+118 ml ) in the study group and
(249.7+147 ml ) in control group. Retained placenta was reported in only two cases of control group
which needed manual removal of placenta.
One case of postpartum hemorrhage due to inertia required blood transfusion was reported in the
control group.
Conclusion: Placental cord drainage is simple ,safe, and non invasive method in reducing the duration
and blood loss in 3rd stage of labour thereby preventing PPH.

characterized by hyperandrogenism, chronic anovulation, and obesity. Obesity is associated with a lowgrade
inflammation of white adipose tissue resulting from chronic activation of the innate immune
system and can subsequently lead to insulin resistance, impaired glucose tolerance and even diabetes.
In the last few years, adipose tissue emerged as an important source of proinflammatory mediators
including TNF- , IL-6, and procalcitonin.
Objective: to investigate procalcitonin as a marker of chronic inflammation in obese women with
PCOS.
Method: a case control study conducted from January 2010 till July 2010. The study involved 20
women with PCOS and 20 control women matched for age and BMI. Waist to hip ratio was measured
and blood was drawn from patients and controls and serum levels of FSH, LH, prolactin, testosterone
and procalcitonin were estimated by VIDAS using VIDAS kits provided by Biomerieux (France).
Student t test was used to evaluate the difference in serum procalcitonin level between the two groups.
Results: compared with control group, patients with PCOS had a significantly higher waist to hip ratio
(mean 0.95 ± 0.2 versus 0.8 ± 0.13). Serum procalcitonin level was significantly higher in women with
PCOS compared to control group (1.43 ± 0.42 ng/mL Vs 0.19 ± 0.13 ng/mL) P value was < 0.0001.
Serum levels of FSH, LH, prolactin and testosterone all were significantly higher in women with PCOS
than in the control group (P value < 0.05).
Conclusion: The increase in low-grade chronic inflammation in women with PCOS is primarily
associated with increased central fat excess. Procalcitonin represents a novel marker of the
inflammatoryactivity of body fat in PCOS.

Background and purpose: Elevation of sera cardiac troponin T (cTnT) concentration and creatine
kinase-MB (CK-MB) activity and electrocardiographic changes can occur after ischaemic stroke. The
aim of this study was to identify the relation ships between elevated cardiac biochemical markers with
ECG changes , stroke severity and in-hospital mortality and to look for source of CK-MB.
Patients and method: From 1 June 2009 to 1 October 2009 this study recruited 70 patients (46 males ,
24 females ) who were admitted to Merjan teaching hospital due to acute ischaemic stroke which
confirmed by neurologist , blood samples were taken for cTnT and CK-MB measurement and ECG
was done. The stroke severity as assessed by Scandinavian stroke scale, and in hospital death were
compared between the two groups of the cTnT and CK-MB. Hypertension and diabetes were separately
compared between two groups of cTnT and CK-MB
Results: Sera cTnT concentration and CK-MB activity were elevated in 22.9% , 35.7% of cases
respectively . ECG changes occured in 45.7% . In contrast to elevated CK-MB activity, elevated cTnT
associated with greater stroke severity and in hospital deaths .ECG changes were more in patients with
elevated cTnT than in patients with elevated CK-MB. CK-MB was not elevated in most patients with
elevated cTnT, the non parallel increase of CK-MB with cTnT signify the non cardiac source of CKMB
. Hypertension and diabetes mellitus were more common in the elevated cTnT patients than
normal cTnT group.
Conclusion: Elevated sera cTnT in patients with acute ischaemic stroke were associated with severe
neurological deficits and in hospital deaths. The elevated CK-MB was mostly non-cardiac source and
not correlated with stroke severity and in hospital death. The elevated cTnT along with ECG changes ,
hypertension and diabetes mellitus signify underlying asymptomatic coronary artery disease.

Germ cells tumors represent a very complicated group of tumors of the ovary and their histogenesis is
not well clarified. They are rapidly growing neoplasms that arise from primordial germ cells derived
from the embryonal gonad. Malignant germ cell tumours comprise less than 5% of all ovarian
neoplasms. Embryonal carcinoma is quite rare, amounting to approximately three percent of ovarian
germ cell tumours. We report a case mixed germ cell tumuor, mainly embryonal carcinoma, in 12
years old female present with acute abdomen due to rupture of the tumour inside the abdominal
cavity.

Sixty nine asthmatic patients (thirty five males and thirty four females) used corticosteroid
therapies as oral tablets and inhaler forms, thirty eight patients used oral tablets and thirty one patients
used inhaler form. Thirty five apparently healthy individuals with out any disease were taken as a
control group.
Blood samples were drawn from patient and control groups after overnight fasting. The serum
obtained from the blood was used for spectrophotometric estimation of the level of total protein,
albumin, chloride, total calcium, phosphorus, total magnesium and zinc concentrations and serum
alkaline phosphatase activity. Sodium and potassium levels were estimated by flame photometer.
Ionized calcium and ionized magnesium levels were calculated by using two mathematical formulae.
The results showed that oral corticosteroid caused significant increase in mean serum sodium level
(P < 0.001), and significant decrease in mean serum potassium (P < 0.001), total magnesium (P <
0.001), ionized magnesium (P < 0.001), zinc (P < 0.001), corrected total calcium (P < 0.001), ionized
calcium (P < 0.001), phosphorus (P < 0.001) and alkaline phosphatase activity levels (P < 0.001) when
compared with those of the control group and those who used inhaled corticosteroid. The significant
decrease in the mean serum chloride is (P < 0.01) when compared with the control group and (P <
0.05) when compared with those who used inhaled corticosteroid.
Also the results elucidated that oral corticosteroid had no significant influence on mean serum total
protein (P > 0.05) and albumin (P > 0.05) levels when compared with those of the control group and
those who used inhaled corticosteroid. The obtained results explained that inhaled corticosteroid had
no significant effect on all the measured parameters when compared with those of the control group (P
> 0.05).
It was concluded that oral corticosteroids possess more undesirable effects on the measured
parameters than inhaled form as appeared by the changes in the measured parameters. Thus, the
measurement of serum electrolytes and the correction of mineral status is quite important during
corticosteroid therapy.

Back ground and purpose :Precordial ST segment depression can occur in patients with acute inferior
myocardial infarction. The aim of this study is to find if there are differences between patients with out
reciprocal changes, patients with reciprocal changes maximum in V1-V3 and patients with reciprocal
changes maximum in V4-V6 regarding the results of echocardiography, angiography and development
of complications and in hospital mortality.
Patient and method :From April 2009 to April 2010, 72 patients with acute inferior myocardial
infarction were included in this study divided into three groups, group I with no ST depression, Group
II maximum ST depression in V1-V3 and group III with maximum ST depression in V4-V6
.Echocardiography was done, patients were followed for development of complications and mortality
and coronary angiography was done to 16 patients.
Results :Remote regional wall motion abnormality was highest in group III 90% compared with group
II 72% and group I 15%.
Ejection fraction was lowest in group III 36 ± 10% compared with group II 42 ± 10% and
group I 56 ± 11%.
Complications and mortality were as follows: group III (60% complication and 20%
mortality) ,group II (32% complication and 8% mortality) and group I (7% complications and 2%
mortality).
Coronary angiography showed multivessel disease in group III (71%) , group II 50% and group I
33%.
Conclusion: Precordial ST depression specially V4-V6 reflects larger infarction size or multivessel
disease thus carries worse prognosis with lower ejection fraction, more regional wall motion
abnormalities and higher complications and mortality.

This study was carried on thirty five subjects (18 patients, and 17 healthy subjects as controls). Their ages ranged
from 40 – 60 years. The patients were diagnosed by specialist physicians by positive troponin I tests, typical chest
pain and changes in ECG. This work was performed in coronary care unite (CCU) ward of Marjan Teaching
Hospital, during period from March to September 2010. The Age, weight, height, WBC count, differential leukocyte
count, ESR, Lipid profile laboratory analysis, Serum total protein, serum albumin, serum globulin, Serum copper,
serum zinc and serum potassium ion level were measured in all subjects.
The results of present study revealed that WBC count, ESR, the differential leukocyte count (e.g. neutroplil cells) in
patients increased significantly (P < 0.01) (P < 0.05) (P < 0.01) respectively comparison to controls. While, the
differential leukocyte count of lymphocyte revealed to decrease significantly (P < 0.05) in patients. Serum
triglyceride, serum total cholesterol, serum VLDL and LDL increased significantly (P < 0.05) (p < 0.05) (P < 0.05)
(P < 0.05) respectively, while, serum HDL decreased significantly (P < 0.01) in patients comparison to controls.
serum globulin, copper and potassium ion showed significant increase (P < 0. 0.01) (P < 0.05) (P < 0.01)
respectively in patients comparison to controls. While, serum albumin, and serum zinc revealed significant decrease
(P < 0.05) (P < 0.01) respectively in patients comparison to controls.

Background. The high kinetic energy produced by the high velocity missiles will create within
milliseconds a cavity in the tissue and results in stretching, compression, shearing, and damage of tissue
that may extend several centimeters away from the bullet and its track. Moreover, a transonic shock waves
will be produced which may cause additional tissue damage in organs that are far away from the track of
the missile. Thus, vessels, nerves, and structures that were never in direct contact with the missile may be
damaged. During routine examination of the heart in high velocity bullet injury victims, we frequently
observed the presence of areas of subendocardiac hemorrhages, varied from several cm2 – all ventricular
wall, especially in those whose injuries were in the thorax, upper limbs, head, and neck. These observations
stimulated us to carry out this study in order to reveal the frequency, significance, and pathogenesis of these
lesions.
Patients and methods. The study included 81 patients; 31 patients who died from injuries by high velocity
bullet and considered as the study group, and 50 patients who died from other causes and considered as
control group. For each patient a full autopsy was performed and the heart was carefully examined. Data
concerning the subendocardiac hemorrhages, their locations and extent were done. Comparison was made
between the study and control groups.
Results. Results of our study have shown that sudendocardiac hemorrhages were present in 83% of patients
who died from high velocity bullet injury. However there were variations in frequency for each region; they
were present in 100% of patients whose bullet injuries were in the head and neck, in 86% of patients whose
injuries were in the chest and upper limbs, and in 20% of those whose injuries were in the abdomen and
lower limbs. These lesions were mostly located at the posterior wall of the left ventricle. They varied in
extents from few centimeters to involve nearly the entire surface area of the posterior wall of the ventricle.
None of the control group has shown these lesions.
Conclusions. The hemorrhagic lesions demonstrated in the left ventricle following high velocity bullet
injuries are most probably produced by the indirect effect of the high velocity missiles on the
subendocardium through the transonic waves produced by the missile during its passage near the heart.

New heterocyclic derivative of 2-Mercaptobenzothiazole have been synthesized: firstly, Schiff base of
2-(1,3-benzothiazol-2-ylthio) acetohydrazide derivatives (3-7) were prepared by refluxing 2-(1,3-
benzothiazol-2-ylthio) acetohydrazide (2) with different aromatic aldehydes and ketones, then two of
synthesized Schiff"s bases (4,5) were cyclized with acetic anhydride formed oxadiazole ring (8,9).
Secondly, [(1,3-benzothiazol-2-ylthio)acetyl]hydrazinecarbothioamide (10) was prepared by reacted
compound (2) with ammonium thiocyanate in dry benzene, then refluxing (10) with sodium hydroxide
(2N) followed acidification by hydrochloric acid solution formed (11) . Thirdly, reacted (2) with
acetylacetone afforded (12) .fourthly, compound (13) was formed by refluxe compound (2) with
ethylacetoacetate; then refluxing (13) using absolute ethanol (98%) and formaldehyde with different
primary amines formed (14-17) and with hydrazides derivatives formed (18-20). finally,
dihydrophthalazine 1,4-dione derivative ( 21) was prepared by condensation of compound (2) with
phthalic anhydride using absolute ethanol and glacial acetic acid. All structures of newly synthesized
compounds were elucidated by elemental analysis and spectral data (IR and UV). Some of the
synthesized compounds (4, 5,8,9,11,12,15,17,20 and 21) were screened for their antibacterial activity.

The study was conducted on sixty three healthy women used combined oral contraceptive pills
(COCPs) and copper bearing intrauterine contraceptive devices (IUDs). Thirty women were used
Microgynon R (low dose COCPs, each pill containing levonorgestrel 0.15 mg and ethinyl estradiol 0.03
mg) and thirty three women used copper T 380A IUDs. Thirty apparently healthy women were taken as
control group. Blood samples obtained from women used contraceptives and control group from
Babylon maternity and pediatric hospital in Hilla city. The sera obtained from the blood were used to
determine the effect of COCPs and IUDs on of malondialdehyde (MDA), total cholesterol, high density
lipoprotein (HDL), triglycerides (TGs), very low density lipoprotein (VLDL), low density lipoprotein
(LDL) and some trace elements (copper, zinc and iron) concentration.
The results of the present study showed (significant increase in MDA, copper, iron, total
cholesterol, TGs, VLDL and LDL concentration), significant decrease in HDL and non significant
decrease in zinc concentration in sera of women who used COCPs when compared to both women who
used IUDs and the control group. Also this study showed non significant difference in MDA, copper,
zinc, total cholesterol, HDL, TGs, VLDL and LDL concentration and significant decrease in iron
concentration in sera of women who used IUDs when compared to those of the control group.

The attractiveness of laparoscopic cholecystectomy has led to a new understanding of biliary anatomy especially
of the Calot's triangle area in order to perform a successful surgery. This study aims to describe the common and
variant anatomy related to the cystic artery during laparoscopic cholecystectomy so that to minimize anatomical
complications and to recommend an anatomically safe procedure. The analysis involved fifty patients who
underwent laparoscopic cholecystectomy by (American technique) at different Iraqi centers during a 6-monthperiod.
Females constituted 84% of the patients. Routine preoperative ultrasound examination revealed gallstones in 86%
of the patients. 18% of the cases demonstrated anomalous vascular anatomy.
Vascular anomalies included caterpillar configuration of the right hepatic artery, a previously unreported right
hepatic artery in the gallbladder bed, and cystic arteries that were early divided, low inserted, and originating from
proper hepatic artery. Hartmann's pouch, cystic lymph node, and the superficial branch of the cystic artery were
recognized as important anatomical landmarks during the procedure

Background To find the most appropriate mode of management in relation to a clot size , level of
Consciousness and Location of haematoma .
Methods Forty two consecutive patient presented with in tracrebral hemorrhage were included in
this study , patient with moderate to large clot and deteriorating in Neurological deficit and
GCS of more than five where included in surgical treatment , while the others patients
treated conservatively .
Result. Level of consciousness , Neurological deficit , Location and size of Haematoma are a
guidelines for surgically or conservatively treatment
Conclusion Surgical treatment preferred in large Superficially haematoma with mid line shift.

This study was conducted to study the therapeutic benefit of metformin in achieving ovulation in
women with ploy cystic ovarian syndrome (PCOS). Twenty eight women received metformin,
ovulation rate was (60.2%). While it was (100%) when we add clomiphene citrate to it. So over all
ovulation rate was (100%) and overall pregnancy rate was (10.8%) which was with metformin alone

Background: From June 2008 to August 2010, we were involved in the management of 166 cases
with suspected bronchogenic carcinoma. Ultrasound-Guided Lung Fine Needle Aspiration Cytology
(FNAC) exam was performed to75 cases .
Aim: To assess the value and safety of ultrasound-guided lung FNAC exam in the diagnosis of
bronchogenic carcinoma.
Methods: FNAC specimens from the lung were achieved under ultrasound guide from clinically fit
patients with suspected pulmonary radiological shadows, immediate cytological study was performed
after staining with Papanicoloua and Geimsa stain.
Results of the 75 patients with FNAC exam:
A) In 57 cases, the results were bronchogenic carcinoma, and the following management steps prove
no controversy between the final diagnosis and the FNAC results, except in one case where the biopsy
result from resected lobe was TB infection, whereas the FNAC result was SCC of the lung (false
positive result).
B) In 18 cases, the results were as follows:
1. Six cases were with different benign looking results, but later investigations prove malignant nature
of the case (false negative results).
2. Four cases were with benign looking results, and their clinical state and radiological changes all
resolve after a complete course of pneumonia management. ( true negative results).
3. Three cases were with TB results with response to anti TB measures (true negative results)
4. Five cases were with benign looking results but they didn’t continue their management under our
supervision.(discharged from the study).
Conclusions: Ultrasound Guided FNAC Exam from suspected pulmonary masses provides accurate
diagnosis with minimal complications.

Pre-eclampsia is a disease characterized by elevation of blood pressure and proteinuria after the 20th
week of gestation.
Serum levels of testosterone, malondialdehyde, reduced glutathione, catalase, total protein, albumin,
globulin, zinc, and copper were determined in sera of 50 pre- eclamptic pregnants and 50 apparently
healthy pregnants who served as control.
The results revealed :-A significant increment in the concentration of testosterone (p<0.01),
malondialdehyde (p<0.01) and globulin (p<0.05) in sera of pre-eclamptics compared to normotensive
pregnants concomitant with a significant reduction in the serum level of reduced glutathione (p<0.05),
catalase (p<0.05), total protein (p<0.05) and albumin(p<0.05) in sera of pre-eclamptics compared to
normotensive pregnants while there is no significant difference in the level of zinc and copper (p>0.05)
in sera of pre-eclamptics compared to normotensive pregnants. Finally a significant positive correlation
between testosterone level and malondialdehyde (p<0.01) in sera of both pre-eclamptics and
normotensive pregnants, a significant negative correlation between testosterone level and catalase
activity (p<0.01) in both pre-eclamptics and normotensive pregnants, and significant negative correlation
between testosterone, and reduced glutathione (p<0.05) in pre-eclamptics; (p<0.01) in normotensive
pregnants.

Objective: We conducted a study to evaluate the short-term functional outcomes of patients with an
isolated tibial shaft fracture treated with locked intramedullary nailing. using a prospective clinical
and radiographic assessment, for union time, time of starting full weight bearing, rate of infection,
knee and ankle joint movement, knee joint pain, and malalignment.
Patients andMethods: We had included 56 patients with isolated tibia fractures from our patients
prospectively followed up in period between Febr.2006 and December 2008 (34 months). 56 patients
agreed to present to our timetable of follow up, 4 patient lost after 3 months of follow up .We had a
median follow-up of 10 months. with a range from 6 to 18 months. All patients were initially acutely
treated with locked intramedullary nailing of their tibia within 48 hours of getting injured . All enrolled
patients were evaluated with Functional assessment, and were evaluated radiographically and by
physical examination.
Results: Of the total number (56 patients), 15 (26.7%) patients had at least moderate knee pain.
6 patients out of 52 ( 11 %) got knee joint stiffness . whereas 2 patients ( 4%) had ankle joint
stiffness , both groups treated by a physiotherapy course .in 90% of the patients ,mean time of union
was 15 weeks ranged from 12- 24 weeks. After getting union those patients started full weight
bearing.Totally 4 patients got superficial wound infection ( 7 %) . ( 12 %) got malalignment , all were
in proximal and distal1/3.
Conclusions: We see that locked intramedullary nailing is a suitable procedure for unstable fractures
of tibial shaft .In contrast to open reduction and internal fixation, intramedullary nailing can be
performed initially on the first or second day of admission.
The advantages of IM nailing include better alignment, earlier range of motion of knee and ankle,
better mobility of patient, less frequent follow up visits, and earlier return to work

Two hundred seventy six samples collected from different sources. The samples were divided into
three groups; first included 40 stool samples collected from healthy individuals; second group included
125 clinical samples from patients who admitted to teaching general Hilla hospital. The third group
included 111 samples collected from environment of same hospital .
The morphological characterization and biochemical reactions showed 33 isolates diagnosed as
Enterococcus faecalis , of which , 15 isolates from normal flora of intestine, 11 isolates from clinical
cases ,and 7 isolates from hospital environment. The results of detection of virulence factors showed
that E.faecalis possessed the followed factors; adhesion factors (45.4%), haemagglutination (87.8%),
hemolysin (15.1%), gelatinase (9.0%) , lipase (6.0%) and bacteriocin (90.9%). The significance of
these factors in the pathogenesis of enterococcal infection needs to be elucidated in further studies.

Background: A variety of cements have been used in dentistry through many years for two primary
purposes: as restorative filling materials, either alone or with other materials, and to retain restorations
or appliances in a fixed position within the mouth. In addition, certain cements are used for specialized
purposes in the restorative, endodontic, orthodontic, periodontic, and surgical fields of dentistry.
Cement solubility and water sorption could be a primary cause of restoration failure.
Aim of study: To evaluate the water sorption and solubility of different commercially available dental
cement materials.
Materials and Methods: Thirty disks (9×2 mm) of zinc polycarboxylate, zinc phosphate and glass
ionomer cements (ten disks for each one) were prepared according to manufactures instructions. After
setting, they were desiccated and weighed and each specimen were immersed in distil water for 7 days,
then removed and weighed again. Then disks were again desiccated and weighed. Solubility and water
sorption values were calculated from these different measures.
Results and Conclusion: The results shows that the polycarboxylate cement show the highest value of
water sorption and water solubility followed by zinc phosphate cement. Glass ionomer cement shows
the lowest values of the three materials tested regarding both water sorption and water solubility

Acute mayocardial infarction (MI) remains a leading cause of morbidity and mortality world wide. MI
occurs when myocardial ischaemia exceeds a critical threshold and overwhelms mayocardial cellular
repair mechanisms designed to normal operating functions and homostatus.
Activity of xanthine oxidase (XO), MDA and vit-C concentrations were determined in sera of 100
patients with MI. Their mean±SD age was (57.05±1.25) year. The same parameters were determined in
sera of 100 apparently healthy matched subjects as a control group. The mean ±SE of XO, MDA, and
vit-C in patients with MI was 0.031±0.016 unit/ mg protein, 1.28±0.053 μ mol/L, 0.520±0.137 mg/dl
respectively while the mean ± SE of control group was 0.012±0.006 unit/ mg protein, 0.819±0.019 μ
mol, and 0.648±0.302 mg/dl respectively. There were significant differences in the mean value of XO
and MDA in patient with MI compared to control group (P<0.001). However the mean value of vit-C
showed no significant differences in both groups.

The research was conducted by (12) College faculty from science faculties at the University of
Babylon's (20) College for the purpose of evaluating what has achieved from adopting a project to
prepare colleges of the University of Babylon, the comprehensive quality management system. The
questionnaire was developed containing a range of expressions is achieved to measure what has been
achieved from the rehabilitation program for colleges of the University of Babylon system, total quality
management and assessment activities to identify and address weaknesses and strengths and to develop
corrective action made to avoid it. It has been developed (33) standard agreed upon and conducted field
increases for the twelve schools to observe and evaluate all changes in form by selecting one of three
levels (to a large extent, to some extent, weak) placed in front of each paragraph of the form.
Subject the results to the statistical analysis, extraction percentage and the mean for each college
and results indicate for the College of Medicine ranked first and Veterinary Medicine ranked second
and the faculties of Nursing and Education (Geber) ranked third in the percentage and arithmetic mean
(90%) of the Faculty of Medicine and (86%) of the Faculty of Medicine Veterinary (84%) of the
faculties of Nursing and Education
(ibnHayyan).