Medical Journal of Babylon

Background The determination of infarct related artery in acute inferior myocardial infarction is extremely important for the prediction of potential complication and predicting the probable site of occlusion is worthwhile because proximal occlusions are likely to cause greater myocardial damage and early invasive strategy is indicated. Objectives:To predict the culprit coronary artery whether right coronary artery or left circumflex artery by examining the surface electrocardiography in patients with acute inferior wall myocardial infarction and also to predict the correlation between the proximity of lesion in right coronary artery and severity of ST segment elevation in inferior electrocardiographic leads that is caused by right coronary artery occlusion . Methods: A total of 56 patients with inferior wall myocardial infarction were included in this study underwent coronary angiography. the electrocardiography of these patients were then compared with angiographic finding to correlate with culprit artery (either right coronary artery or left circumflex) and also to correlate the proximity of culprit lesion in right coronary artery with the degree of ST segment elevation in inferior limb leads. Results: After comparing the electrocardiographic findings in inferior and lateral leads ,it was evident that the degree of ST segment elevation in leads III and AVF was significantly higher in right coronary artery group (46 patients) vs left circumflex group (10 patients) 3.16±1.14mm vs 1.53±0.24mm (p<0.001) and 2.78±0.92mm vs 1.2±0.25(p<0.001)respectively. While its comparable in lead II 2.18±0.95mm vs 1.7±0.34mm (p>0.05).In respect to lateral limb leads (AVL and I), we found that deeper ST segment depression was in right coronary artery group as compared to left circumflex group 1.11±0.25mm vs 0.2 ±0.34mm (p<0.001) and 0.69±0.25mm vs 0.25±0.42mm (p<0.001). In precordial leads V2 and V3 we found that the left circumflex group had deeper ST segment depression compared to RCA group although the difference was of no statistical significance 1.9±0.56mm vs 1.55±0.76mm (p>0.05)and 2.1± 0.56mm vs 1.73±0.71mm (p>0.05) respectively. Also in right coronary artery group, 15(32.6%) patients had proximal culprit lesion, 19(41.6%) mid and 12(26%) distal culprit lesion. Patient with proximal right coronary artery disease showed a mean ST segment elevation of 11.7±1.8mm and with mid right coronary artery disease 7.2±0.97mm and with distal right coronary artery disease 5.8±0.82mm. Conclusion 1-It is possible to predict the culprit artery whether right coronary artery or left circumflex by examining the surface electrocardiography in patients with acute inferior myocardial infarction. 2-The degree of ST segment elevation is correlated with proximity of the right coronary artery.

Diabetic nephropathy is a leading cause of DM-related morbidity and mortality. Pathogenesis of
diabetic nephropathy is related mostly to chronic hyperglycemia.
The study was designated to estimate some possible risk factors of diabetic nephropathy and
assessed clinically , haematologically the patients with diabetic nephropathy, since the changes in
these parameters are important in detecting, quantifying, identifying some possible risk factors and
assessing patient’s response to treatment.
The patients and controls enrolled in this study had undergone full assessment that included:-
clinical assessment by history and examination, haematological assessment (measurement of RBCs
counts, blood Hb and PVC and RBCs indices), hormonal study(serum erythropoietin level).
The study revealed that diabetic nephropathy prevalence more in female with long duration of DM.
In regard to haematological parameters the results of study show that there is highly significant
decreased (p< 0.01) in RBCs counts, blood Hb, PCV and RBCs indices , as well as serum
erythropoietin in diabetic nephropathy patients in compare to control groups.
In conclusion, diabetic nephropathy associated with increased and decreased in some
hematological parameters may be attributed to anemia that accompany diabetic nephropathy.

A total of 102 soil samples were collected from different sites in Babylon province, Iraq during the
period from May to August 2010. According to morphological and biochemical tests, twenty isolates
of actinomycetes were recovered and finally identified as Streptomyces species (19.6%) of which 4
isolates were belong to Streptomyces gelaticus which represent (20%) of all Actinomyctes organisms.
The cultural characteristics of Streptomyces gelaticus isolates showed that the color of aerial
mycelium was grey, substrate mycelium was yellowish brown to green with no pigmentation on YMD
agar medium, and no melanin production. The antibacterial activity of S. gelaticus SAM 10 isolate
against three pathogenic bacterial species; Staphylococcus aureus, Pseudomonas aeruginosa and
Escherichia coli, was assessed using well diffusion method. The inhibition zone diameter for S. aureus
was 19.9 mm while it was 10 mm for both of E. coli and P. aeruginosa respectively. The present study
represents the first record of isolation of Streptomyces gelaticus in Iraqi soil.

The aim of this study was to evaluate the Antibacterial activity of various concentrations of mixtures
of Thymus vulgaris and Negilla sativa on various pathogenic bacteria (Escherichia coli,
Pseudomonas aeroginosa, Staphylococcus aureus, Enterococcus faecalis, Serratia sp. and Bacillus
subtilis )
In general, all extracts in concentraction (40 ?g/ml) have the same effects on Gram positive bacteria (,
Staphylococcus aureus, Streptococcus faecalis, and Bacillus subtilis) , whereas the less effect on
Escherichia coli (60 ?g /ml), the biggest effect on Serratia sp. (20 ?g /ml) and Pseudomonas
aeroginosa was (40 ?g /ml)
The limits of minimal inhibitory concentration (MIC) of all extracts are between (10-320 ?g /ml).
The efficiency of antibacterial activity of T. vulgaris and N. sativa extract were compared with
efficiency of standard antibiotics against (Ampicillin, Amikacin, Erythromycin, Kanamicin,
Tobramycin, Imipenem, Neomycin, cephalothin, Cephalexin and Augmentin) the same bacterial
types.

Propolis samples were collected during spring and summer seasons (2010 and 2011). Bacterial and
yeast strains; standard bacterial strain represented by E. coli ATCC 25922 and S. typhi TY21, while the
local bacterial isolates represented by S. aureus, P. aeruginosa, S. pyogenes, L. monocytogenes, H.
pylori, E.aerugenes, S. typhi, K. pneumoniae, and C. albicans.
Antimicrobial activities of crude ethanolic extract of Al-Museiab propolis (EEMP) against bacterial and
yeast isolates evaluated. Results revealed that S. aureus was higher sensitive to 10% concentration of
EEMP than other Gram positive and Gram negative bacteria, while standard E. coli strain was highly
sensitive to EEMP than other Gram negative bacteria. EEP was not effective against C. albicans.
The results of Amoxicillin–propolis combination on the bacterial isolates were; synergistic to words P.
aeruginosa, H. pylori, E. coli and K. pneumoniae, while the results of clindamycin-propolis combination
on the bacterial isolates were; synergistic to words P. aeruginosa, H. pylori, K. pneumonia, and E.
aerugenes. The results of Rifampin-propolis combination on the bacterial isolates were; synergistic to
words on P. aeruginosa, E. coli, K. pneumoniae, S. pyogenes, and E. aerugenes. Last but not least, the
effect of Nistatin and propolis combination against C. albicans isolates indicated for additive effect.

Purpose: We evaluate the use of a transurethral resection with radiotherapy in the treatment of
operable transitional cell carcinoma of the bladder with potential bladder preservation.
Materials And Methods: A total of 143 consecutive patients with T2-T3 bladder tumors
underwent as complete transurethral resection as possible. They then received radiation therapy for
6-7 weeks. Following that, patients were reevaluated cystoscopically and ultrasound imaging. Of
the 143 patients 92 have complete clinical response, undergo 3-6months cystoscopic examination
for two years. 48 Patients had incomplete responses.
Results: Of the 143 patients 92 had no detectable tumor after induction therapy. 48 Patients who
had incomplete responses, 11 of them were undergo an immediate radical cystectomy. 3 patients
die during period of radiotherapy, and 12 patients, die during period of follow up and treatment.
The mean age of our patients was 57 years, 106 male patients and 37 female patients
Conclusions: This study demonstrates a high rate of response to this combined radiation regimen
in conjunction with a visibly complete transurethral resection. The results of bladder sparing
approach for the treatment of muscle-invasive bladder cancer, using a combination of transurethral
resection (TUR) and radiotherapy, are encouraging and increase the survival of patients treated by
this method.

This study is aimed to measure the serum levels of immunoglobulin A (IgA), (IgM), and (IgG) in
BTM patients with respect to their iron overload, and methods of treatment. A total of 81 BTM
patients were enrolled in the study among them 12 patients were just diagnosed under no treatment to
serve as a second control group beside the first one which is composed of the healthy subjects. All of
the study groups (patients on scheduled blood transfusions, subcutaneous (Sc.) Desferrioxamine (DFO)
infusions beside blood transfusion, who were also subdivided into spleenectomized and non
spleenectomized patients) were compared firstly with the healthy controls, secondly with the newly
diagnosed thalassemics and a third type of comparisons was done among the study groups themselves.
Blood samples were taken from every subject involved in the study to obtain the serum. The results
showed that in comparison of the DFO infusioned thalassemics with the healthy controls a highly
significant (p›0.01) increase in IgA, IgM, IgG were found. In comparing the spleenectomized patients
with the healthy controls a highly significant increase were found in IgA, IgG, IgM, (p›0.01) while the
non spleenectomized patients showed a highly significant increase in IgA, IgM(p›0.01). blood
transfused thalassemics when compared to the newly diagnosed thalassemics showed a significant
decrease in IgG and IgM levels(p›0.05). DFO infusioned thalassemics when compared to the newly
diagnosed thalassemics showed a significant decrease in IgM(p›0.05). In comparing blood transfused
with the DFO infused thalassemics, the latter group showed a significant increase in IgA, IgG and
IgM(p›0.05).In comparing the newly diagnosed thalassemics with the healthy controls, a highly
significant increase was found in IgG(p›0.01), while IgM showed a significant increase(p›0.05). The
spleenectomized patients showed a significant increase in IgG only (p›0.05) when compared to the non
spleenectomized patients. No significant correlation was found between serum levels of ferritin and
any of the three immunoglobulins.It is concluded that repeated blood transfusion, iron overload, and
spleenectomy are interacting contributing factors to the immune abnormality in BTM patients.

In this study in vitro potencies of some antibiotics were compared singly and in combination with
probiotic released by Lactobacillus acidophilus isolated from local yoghurt against multi-drugs
resistance Pseudomonas aeruginosa. Doxycycline, chloramphenicol and ciprofloxacin were randomly
selected for this study. Lactobacillus acidophilus had characterized according to it's specific
characteristics; e.g. colonial morphology, cellular morphology and biochemical tests. Crude product
of this organism in Modified Rogosa sharpe broth medium was used as probiotic against multi-drug
resistant P.aeruginosa being isolated from sever infected burns. The probiotic and antibiotics included
in this study were used separately and in combination against P.aeruginosa. Combination of probiotic
with chloramphenicol resulted in inhibition zone of 24 mm. in diameter compared with 9mm and zero
for each of probiotic and chloramphenicol alone respectively. It is of synergy action.
Combination of probiotic with doxycycline revealed an inhibition zone of 19 mm in diameter versus 9
mm for each of probiotic and doxycycline alone when used separately indicating for synergy action as
well. A third combination included ciprofloxacin with probiotic yielded an inhibition zone of 24 mm.
in diameter while ciprofloxacin alone revealed an inhibition zone of 30 mm. indicating for
antagonistic action.

Back ground: Chronic gastritis defined as histopathological entity that characterized by chronic
inflammation of the gastric mucosa. There are three different types can be distinguished: gastritis A
the result of an autoimmunological process with antibodies against parietal cells and intrinsic factor
and is confined to the proximal stomach. Distal, antral gastritis B which is caused by an infection of
the gastric mucosa with H. pylori. Gastritis C may be caused by drugs and alcohol but is mainly found
in gastric remnants after partial resection as a consequence of biliary reflux.
Aim: To give a detailed histolopathological study of chronic gastritis with and without intestinal
metaplasia and relationship between H pylori infection and chronic gastritis at GIT center at Babylon
according to the Modified Sydney system.
Methods: Gastroscopic biopsy specimens from 50 consecutive patients from GIT center at Babylon
were examined histologically after staining with hematoxylin /eosin and modified giemsa stain and
graded according to the Updated Sydney System for H. pylori infection, chronic inflammation,
neutrophil activity, glandular atrophy and intestinal metaplasia.
Results: The rate of the graded variables, in the antrum and corpus respectively, were as follows: H
pylori infection (82%, 78 %), chronic inflammation (98%, 78%), neutrophil activity (70%, 62%),
glandular atrophy (12%,8%) and intestinal metaplasia (11%, 5%). Significant association was found
between the degree of H pylori colonization with chronic inflammation, less degree of neutrophil
activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant
histopathological discordance for all the graded variables.
Conclusion: The study shows that the majority of patients show a mild to moderate degree of
inflammation with or without intestinal metaplasia, still less degree of glandular atrophy some time
present. The study confirms that H pylori is the chief cause of gastritis in the study patients. The study
also shows that interrelationships between the histological variables in those patients are similar to
those found in other populations worldwide.

Back ground: In patients with a history of systemic cancer(out side the spinal column) , presented
with persistent back pain, the early detection and management of spinal metastases is of utmost
important to help with pain control, prevent further spread and development of neurological
complications.
Objective: To determine and evaluate the importance of spinal percussion, as a physical sign , and as
evidence of spinal metastases.
Methods: A prospective study of 61 patients with a history of systemic cancer , presented with back
pain and suspicion of spinal metastases, was carried out.
Full medical history and physical examination, including entire spinal percussion with a reflex
hammer, were done for all patients.
All patients had ESR , serum alkaline phosphatase estimation and plain radiographic study of entire
spine.
All patients had MRI scanning.
Results: The spinal percussion sign profiling as a red flag, carried a high sensitivity of 90% and
specificity of 89.4% aiding in identifying the spinal metastases.
Conclusions: This test will help in prediction which patient with a history of primary cancer
presented with back pain , have a high possibility of spinal metastases that need the priority , or at
least to put them on the first line of waiting list of MRI for final diagnosis

This study included, 100 urine samples obtained from patients suffering from Catheterassociated
Urinary Tract Infection (CAUTI) and admitted to Hilla Teaching Hospital for Surgery
for the period from October 2010 to February 2011 in Hilla city. Out of 78 positive cultures, only
three isolates showed positive for Morganella morganii (3.8 %), one from male and two from
females.
Phylogeny markers used in detection of Morganella phylogeny were E.coli phylogeny
markers. These include yjaA, chuA and TspE4C2. The results showed that one isolate was
positive (amplicon) for yjaA, and two isolates for TspE4C2 but none of them was positive for
chuA. Since the isolates are positive to yjaA and TspE4C2. So, they belong to phylogenitic group
A and B1 respectively (intestinal group). This may conclude that the Morganella source (in UTI)
is intestinal.

Diclofenac sodium isa non steroidal anti inflammatory drug (NSAIDs). The present study was
conducted to assess the effects of Diclofenac sodium on some hematological parameters,on male
rabbits. The study was carried out in the animal house of College of Medicine-Babylon University at
the period from 1 Dec. 2009 -1Mar. 2010. Twenty local male rabbits were divided in to two groups,
(control and treatment ).The drug was given intramuscularly once a day. Along the study period
Diclofenac sodium is given for 45 days and, blood samples were obtained every 15 days for
hematological study , while at day 60 blood samples are used for hematological and immunological
study. As a results of this study,Diclofenac cause significant decrease (p< 0.05) in hemoglobin conc.
and hematocrit percentage and significant increase (p< 0.05) in reticulocyt percentage as compared
with control group. As for WBCs related parameters there is non significant difference (p> 0.05) in
total WBCs count of all the three treated group as compared with control group. On the other hand
differential WBCs count show significant decrease (p<0.05) in neutrophils count and significant
increase (p< 0.05) in lymphocytes count of treated group as compared with control group. Diclofenac
treated animals show erythroid hyperplasia. In conclusion Diclofenac used in this study caused
anemia and neutropenia and these effects were due to immune and non immune mechanisms.

Objectives: To identify the prevalence of enterococci species in hospitalized patients with urinary
tract infection in Hilla City, to determine their susceptibilities to vancomycin and other antibiotics.
Materials and methods: Two hundred urine samples were obtained from patients who were admitted
to three main hospitals in Hilla city during a period of three months (from November 2010 to
February 2011). After identification of enterococcal species by biochemical tests, the antibiotic
susceptibility of isolates was determined by standard disk diffusion test according to CLSI. MIC tests
for vancomycin and teicoplanin were also carried out for VRE isolates by methods of agar-dilution
and HiComb test.
Results: This study revealed that out of 200 samples, Enterococcous species was isolated only from 7
samples, which were identified to genus level. 5/7 isolates were catheter-related infection. According
to susceptibility data obtained, Five isolates were resistant to vancomycin (71.43%) with an MIC
ranging from 8-32 ?g/ml but they were sensitive to teicoplanin (MIC < 0.25 ?g/ml), thus exhibited
VanB phenotype, and the majority of isolates (86%) showed multi-drug resistance pattern. All isolates
were highly resistant (85.72%) for each of chloramphenicol, rifampicin and erythromycin. On the
other hand, 71.43% of isolates were resistant to each of penicillin and tetracycline while they were
moderately resistant to ampicillin (57.14%) and ciprofloxacin (42.86%), in comparison to relatively
low resistance to nitrofurantoin 14.29%.
Conclusion: Finding of this study shows an emergence of VRE along with increased rate of multidrug
resistant enterococci in the area of the study.

Objective: To estimate some biochemical changes in patients with bladder cancer.
Patients: One hundred patients admitted to Al-Hilla General Teaching Hospital and to the
Radiation Oncology and Nuclear Medicine Hospital in Baghdad, and 30 healthy controls were
included in this study which lasted from February to June 2011. The patients included 72 males
and 28 females, their ages ranged from 41-84 years, with
a mean age of 63 years. Those patients were divided into male and female subgroups. As well as,
the healthy controls were matched in age and sex with them.
Results: This study demonstrated that the majority of patients (42%) fall in the age group 60-70
years; the male to female ratio was 2.57:1 with 72% of patients being males and 28% being
females. Smoking was the most important risk factor for developing bladder cancer accounting
for 55% of patients followed by occupational exposure (42%) and environmental exposure
(15%). Further; 80% of patients were found to have stage II and III disease accounting for 50%
and 30%, respectively, and 95% of patients presented with grade II and III disease, being 64%
and 31%, respectively. The most common type of bladder cancer was transitional cell carcinoma
accounting for 95% of patients.
The total serum protein, albumin and globulin were found to have a significant
decrement; whereas C-reactive protein was significantly increased in both male and female
patients compared to the control group. Serum iron and calcium were significantly decreased in
both male and female patients in comparison with the control group. Serum zinc was
significantly decreased while serum copper showed a significant increment in both male and
female patients compared to the control group.
Conclusion: The changes of all previously mentioned markers in bladder cancer patients might
be potentially important findings as a biochemical tools for the disease.

This study was designed to estimate some physiological changes to the burn patients ,since the
levels of these substances are very important in letting the health care team to know how the body is
responding to the different therapies that being provided and this will help the medical staff for
proper management with less morbidity and mortality. The study lasted from November/2007 to
May/2008. There are 125 patients and 100 healthy controls (clinically assessed by specialist doctor)
are taken in this study .The patients are classified in 5 groups .The ages of these groups were divided
as follows: the first group (1-<3 years) ; the second group (3-<5 years) ; the third group (5-<10 years);
the fourth group (10 - <18 years);and the fifth group (18 - 58 years old ) . Those patients were
admitted to the burn unit at Al-Hilla General Teaching Hospital. They were suffering from second to
third degree (flame and scald) burn injury .
Concerning the hematological parameters , it is found that hemoglobin (Hb) and packed cell
volume (PCV) shows significant decrease ( p<0.01) in comparison with healthy controls.
Regarding the biochemical parameters ,it was found that the total serum protein , albumin and
globulin of male and female burn patients shows significant decrease(p<0.01) for all age groups
except the males of fourth and fifth groups and the females of fifth group which show significant
decrease at level p<0.05. The serum electrolytes , serum sodium and potassium shows a significant
decrease ( p<0.01) before resuscitation and significant increase ( p<0.01)within 2 days duration after
resuscitation for male and female burn patients of all age groups . Finally , the serum of calcium
,copper and zinc shows significant decrease p<0.01) for males and females of all age groups except
the males of first and fourth groups and the females of first and third group which show significant
decrease at p<0.05 for zinc only in comparison with healthy controls.
In view of the changes summarized , the increase or decrease in some hematological and biochemical
parameters may be attributed to hyper metabolic state which arises mainly due to increase of
adrenaline release ,loss of fluid and electrolytes , hemolysis and sepsis .

This study aims at studying the effect of zinc and copper level on the cell mediated immunity
against tuberculosis.This work was applied on 60 TB patients admitted to the Babylon Center of
Tuberculosis and Chest Diseases from October 2009 to January 2010.
TB patients consisted of 38 males and 22 females with age range 9-60 years .This study involved
also 40 apparently health subjects as controls, which consisted of 25 males and 15 females with age
range 10-60 years. Blood samples were collected from patients and control to estimate phagocytic
index, and interferon gamma (IFN- γ). Zinc and copper level were also spectrophotometerically
estimated. The cell mediated parameters showing a significantly decreased (p< 0.05) in phagocytosis
activity in TB patients (7.3%) compared to control group (11.6%) and no significantly increased
(p> 0.05) of IFN- γ level in the TB patients (0.123) IU/ml compared to control group (0.071) IU/ml
.The zinc level in serum was significantly decreased (p<0.05) in the TB patients (58.27) μg/dl
compared with control (79.92) μg/dl and copper level was significantly increased (p<0.05) in the TB
patients (148.36) μg/dl compared with control (89.16) μg/dl .The results provide a good correlation
between the levels of zinc and copper ;and the cellular immunity against tuberculosis.

Objective: To determine the impact of preemptive epidural anaesthesia and analgesia on
postoperative pain and other clinically important outcome variables after transvesical retropubic
prostatectomy.
Patients and method: A total of 28 patients undergoing transvesical prostatectomy for the treatment
of benign prostatic hypertrophy were randomized to either group A (10 patients underwent the surgery
under general anaesthesia. And the other 18 patients scheduled in whom an epidural catheter for
anaesthesia and treating postoperative pain.
Epidural bupivacaine 0.5%, was administered for induction of anesthesia and throughout the entire
operation, followed by aggressive postoperative epidural analgesia for all patients in group B, pain
scores obtained 48 hours,Pain recorded by using visual analogue scale VAS.Evaluation of our
perioperative anaesthesiologic regimen, in terms of safety, patient comfort, the time in operating room
and recovery room, average blood loss(depending on pcv & Hb%). time to return of bowel function,
duration for need to bladder wash.
Results: There were no significant differences between the groups with respect to age, height, weight,
or operation time. Regarding the operative time in the operating room revealed no differences in both
groups ( 60--90 minutes including the time of induction of anaesthesia),but the time needed in
recovery room for those patients with GA about 15—40 minutes. The recovery time of bowel function
in group B (8—12 hours) was less than that for group A ( 16—24 hours).The duration for irrigation of
bladder wash in group A was 42--72 hours, while for those in group B was 24—42 hours. The need
for blood transfusion in 6/10(60%) in group A, and 4/18(22%) in group B. The postoperative pain
score using VAS, The results revealed there is a significant difference of the pain score between
group A(7.65+/- 1.56), and 1.25+/-0.2 in group B
Conclusions: The epidural catheter for anaesthesia and preemptive administration of epidural
analgesics can lead to long-term decreases in postoperative pain and earlier resumption of normal
activities.

Background: Vitiligo is a common and chronic disease with a great impact on patients’ quality
of life. Phototherapy with narrowband ultraviolet B radiation is one modalities that are used
increasingly for the management of the disease with variable results. In this study we review the
efficacy, adverse effects, of narrowband ultraviolet B in the treatment of recalcitrant vitiligo in
patients not responding to the topical and systemic steroid nor to topical or systemic psoralen.
Patients and methods: Twenty-two patients with vitiligo (whom not response to topical steroid
or topical or systemic psoralen) were included in this study their ages ranged from 6 to 45 years
with a mean of 26.733 years ±8.11 SD, with vitiligo and Fitzpatrick’s skin type II–IV from our
outpatient clinic were included in the study. The duration of the disease was ranged from 1-17
years, with mean of 6.71 years ± 4.22 SD. All patients did not taken treatment for at least 3
months.
exclusion criteria were patients with a history of skin cancer or dysplastic naevus
syndrome, photosensitivity or using photosensitizing medicine, psychiatric or epileptic
disorders.
Before the study the surface area patches ranged between 4 cm2 to 38 cm2. The
initial irradiation time was 36 seconds (200 mJ/cm2) then increase gradually with every visit by
9 second (50 mJ/cm2) if no any side effect was occur continue with increasing scale up to 3
minutes (1666 mJ/cm2) for five months (forty sessions) . All patients were treated with narrow
band UVB machine twice weekly (not consecutive days) .No phototesting was done before the
treatment.
Results: All twenty-two patients with vitiligo were completed this study. (10 males and 12
females).
The results of 22 patients treated with narrow band UVB machine twice weekly (not
consecutive days) as follow. The mean size of patches before treatment were 16.61±7.99 cm2
after one month become 15.23±7.27 cm2 , this size continued to decrease reaching to
12.96±6.521 cm2 by two months; at three months the size of lesions become 10.73±5.841 cm2 ,
the size continued to decrease reaching to 9 ±5.790cm2 in the end of fourth month, while
reaching to 8 ±5.581cm2 in the 5th month .The repigmentation grading was as follows after 20
weeks of treatment grade 0 were 2 patients (9.09 %) , grade I were 3 patients (13.63 %) , grade
II were 5 patients (22.72 %), grade III were 7 patients (31.81%), grade IV were 5 patients (22.27
%) . 54.54% of the patients showed more than 50% (grade III and grade IV) reduction in the size
of vitiligenous area. P value was extremely significant (p=0.0003) .
Conclusion: Treatment with narrow band UVB was relatively safe and effective in treatment of
recalcitrant vitiligo and has no side effects except transient erythema.