The Medical Journal of Tikrit University

Amebiasis caused by Entamoeba histolytica is a third leading causes of death in worldwide. Little is known about its occurrence of parasite in subjects with cancer patients after receiving chemotherapy. This study aimed to determine, the frequency of E. histolytica in cancer patient admitted to oncology department in Kirkuk Teaching Hospital . X'resh stool specimens collected from 93 patients, detected by the E. histolytica / E. dispar olyclonal EILISA tests. Solid tumor form were the predominant type (65/93;69.E%)while the hematological cancer form were 30.1o/op8193, according to type of stool the high rate was demonstrate in semi +olid stool while according to color of stool was demonstrate in yellow colored stool. Cancer patients with E. histolytica / E. dispar were mostly from urban area then from rural area . E. histolytica / E. dispar positive cases occurred in patients whose their family were )6 individuals. And The high E. histolytica /8. dispar were demonstrated positive cases in illiterate individual

Amoebic dysentery is an endemic disease in Iraq. Serious steps are needed in order to decline infection ratio and to prevent any complications resulted from this disease.
The study was carried out in vitro to evaluate the efficacy of some chemical drugs on the viability of Entamoeba histolytica isolated from human in culture.
Locke egg medium was used as growth medium for isolation of Entamoeba histolytica. Best results were obtained using this medium in isolation of trophozoites. After isolation, trophozoites were tested against a variety of chemical drugs using Pandroff tube which contain Jones broth medium. Various concentrations were used from chemical drugs which included metronidazole, albendazole, and mebendazole.
Entamoeba histolyica was diagnosed in 514 stool samples (41.12%) from a total of 1250 examined sample.
Assessment of the results was done by estimation of viable trophozoites in haemocytometer chamber. The viability of trophozoites was estimated using various concentrations of (100, 50 and 25 mg/ml) of metronidazole, albendazole and mebendazole.
Metronidazole was found to have a best inhibitory effect against Entamoeba histolytica, followed by albendazole and mebendazole which was less effective in comparison with metronidazole.

Background: cfomegalovirus (CIvfD has been described as an important etiological agent of intrauterine infection in women of childbearing age that causes congenital malformation .This infection constitutes a major economic and public health problem in the world particularly in the developing countries including the Middle East due to the high rate of morbidity and mortality especially, among pregnant women and patients.
Objective: This study was carried out to determine the prevalence of toxoplasmosis and infection among aborted women in order to establish basic knowledge for future pregnancy care.
METHOD: The study included 126 women with abortion, across sectional study performed; Serological evaluation for TORCH infections was carried out by IgG and IgM ELISA method.
Results: A total number of 126 blood samples from aborted women was collected and tested for the presence of IgG and IgM concerning CMV.I0l(80.2%) were seropositive while 25(19.8%) were seronegative.
Conclusion: CMV infection is more prevalent among aborted women. A previous history of pregnancy wastage and the serological reaction for TORCH infections during currentpregnancy must be considered while managing BOH cases so as to reduce the adverse fetal outcome.

The cross sectional study was designed to investigate the effect of antioxidant vitamin E 400mg daily dose in patients with hJperlipidemia for nine months. The study was performed on 90 patients (36 males and 54 females) from medical clinic in the Al-Qadsia arealTikrit city.
Results: The study was showed the level of triglycerides significantly decreased after three months of treatment in both female and male, the level of total cholesterol was significantly decline after three months of treatment in female and male, the level of HDl-cholesterol is significant decline after six months of treatment in female and after nine months in male, the level of VlDl-cholesterol is significantly decreased in female after nine months of treatment and after three months in male, while the level of LDL -rcholesterol is significantly decreased after three months of treatment in both female and male. There is some side effect appear in some patients during the course of treatment in study as abdominal pain, gastrointestinal disturbance and fatigue.
CONCLUSION: This study was recorded the significantly decline in triglycerides, total cholesterol, LDl-cholesterol, followed by HDL and VLDL levels in females patients with hyperlipidemic, on the other hand, total cholesterol, triglycerides, VLDL levels showed the greatest reduction followed by LDL, and HDl-cholesterol levels in male patients with hyperlipidemic after using vitamin E in a dose 4}0mglday for nine months.

P.aeruginosa is one of the most danger cause of morbidity and mortality in patients in nosocomial infection and renal failure. ELISA method this assay has high sensitivity and excellent specificity for detection oflruman PEA. The medical records of 64 patients (42 males and 22 females of renal failure patients ) undergoing hemodialysis at the Department of Nephrology-hemodialysis of the Tikrit Teaching Hospital from (12 - 2012 to 12-2013 ) were retrospectively reviewed. Control of exotoxin concentration is zero because the minimum detectable dose of human PEA concentration is typically less than 0.039ng/ml depend on sensitivity of ELIZA kit.Detectable exotoxin A in serum of 64 patients The result showin this study maximum concentration was 3.5 nglml .positive result was 37 males of 42 and 17 females of 22.and no significant exotoxin A concentration between males and females.

Breast cancer is a complex disease and may be sub-divided into hormone-responsive [estrogen receptor (ER) positive] and non-hormone-responsive subtypes (ER-negative), and remains a common disease throughout the world and endometrial cancer is the most common gynecological malignancy.
This study aimed to detect the relationship between estrogen hormone as a risk factor and development of breast and endometrial cancer.
Out of(156) cases, only (62) cases ofbreast cancer depended upon data collection ofpatients and (94 ) cases with reports during from first of January to last of march 2014.
The result revealed that at the age (40-49) years was (38.3%), P<0.005 followed by the age (50- 59) years (22%), P<0.005 ,so that the results were significant.
Ductal type of breast cancer recorded (86.8%) while lobular type recorded (13.|%)Left side of breast cancer recorded (56.36%) while right side (43.63%) .Endometrial cancer was recorded at the age (40-49) years (75Yo) followed by (50-59) years (l2.5oh) P<0.005, so it is significant.
It was concluded that the estrogen status effects on development of breast cancer mainly.

Background: Spontaneous miscarriage is the unintentional expulsion of an embryo or fetus before the 24th week of gestation affecting up to I -5% of couples trying to establish a family .ln addition to a recorded increase in the rate of spontaneous miscarriage among the Iraqi women at all ages and all over the country where an interplay of several etiologies, occupational, environmental and Iifestyle factors were suggested to be the causes of the miscarriage.
Aim: To explain the association between occupational, environmental and lifestyle factors affecting the spontaneous miscarriage in Kirkuk city.
Patients &Mejthods: A total of (500) pregnant women in the age of (18-48) years old attending the outpatient of Obstetrics and Gynecology at Azadi Teaching hospital in Kirkuk city during the period from December (2010) to December (2012). Data used in the research were collected using a questionnaire designed for this study.
Results: From a total of (500) pregnant women subjected to various laboratory tests and to strict examination by the Obstetrics &Gynecology consultant, about (478) healthy pregnant women were selected and were subdivided into two groups; the first group included (328) women whom pregnancies were terminated by spontaneous miscarriage in the first trimester (<13 weeks of gestation), the other group included (150) women who had progressed to delivery. The results of the occupational factors inquiry showed that, teaching and medical occupations significantly affected pregnancy outcomes (p<0.05) and increased the spontaneous miscarriage compared to the results showed by the other occupations. A comparison between rural and urban results of pregnancy outcome showed a significant increase (p<0.05) in the spontaneous miscarriage rate among the urban patients (79.1%). Moreover, the lifestyle factors that included smoking, coffee and stress allshowed significant increase (p<0.05) in the percentage of spontaneous miscarriage in about (63Yo, 66.lyo and 89.6%) respectively.
Conclusions: Results showed a high rate of spontaneous miscarriage among the pregnant women in Kirkuk city during the period from December 2010 to December 2012 especially among teaching and health professional occupations. Besides the frequency of spontaneous miscarriage was higher in urban than in rural area in addition to Lifestyle factors that included smoking, coffee intake and stress which significantly increased the rate of spontaneous miscarriage.

Preeclampsia is an exacerbation of generalized inflammatory response, physiologically present in the third trimester of pregnancy.
Aim: To evaluate TM-cr and hs-CRP measurement in the context of preeclampsia.
Patients and methods:
A case control study design was performed. The study included (25) non pregnant women (groupl), (25) normotensive pregrrant women (goup 2) and (25) pregrrant women complicated by preeclampsia of singleton gestation in the third trimester (group 3) who were attending AL- Batool teaching hospital and AL- Hadba antenatal clinic in Mosul city during a period of 6- months from 1 st November 2012 to lst May 2013. For urinary protein determination of proteinuria by reagent strip was done.
Serum hs-CRP and TNF-a levels were determined using enryme linked immunosorbent method. Results:
The results obtained revealed a highly significant increase in circulating hs-CRP levels in the last trimester of pregnancy compared to non pregnant women with p<0.0001, and a sigrrificant increase in serum TNF-cr and hs-CRP levels were also found among preeclamptic women with p < 0.001 compared to normotensive pregrant women.
While, TNF-cr, showed a significant positive correlation with hs-CRP in preeclamptic women (r- 0.47, p<0.001).
Conclusion:
Data of the present study show that both hs-CRP and pro -inflammatory cytokines are present in higher concentrations in women with preeclampsia which highlight the importance of measuring hs-CRP, TNF-δ in preeclamptic women which may contribute to the pathophysiologl of this pregnancy disorders.

Neonatal sepsis is a clinical syndrome characterized by many signs and symptoms which are non specific for diagnosis. Blood culture is standard measure but needs time to give it's results. Monocyte count is now used for early detection and follow up of patients of neonatal sepsis. The aim of the study is to evaluate the relation between the type of microorganism and some hematological parameters in neonatal sepsis The number of studied cases were 46 neonates diagnosed as a cases of neonatal sepsis after positive blood culture. Each one was assessed clinically by prepared questionnaire including history and clinical assessment. Laboratory parameters includes WBC count, ESR, and monocyte count were done for all included cases. Very early neonatal sepsis was the commonest clinical type of sepsis 30(65/%) with poor feeding is the common presentation a0(87%).Group B. streptococcus was the commonest bacteria isolated in l7 cases (37%).At time of diagnosis monocyte, ESR, and wBC count were high in 3l(67,4yo),26(56,5oh)and 28(60p0 ) respectively. Most of the bacteria show nearly similar presentation of normal and high W.B.C. count except for staph aureus which shows all W.B.C. count is high 6(100%). All types of bacteria show nearly similar normal and high E.S.R. except for staph aureus which shows most of cases have high E.S.R. The high percentage of high monocyte count was in Coagulase negative staph , E.coli and staph aureus l0(76.9o/o),8(80%)and 4 (66.7%) respectively, while the normal monocyte count was nearly similar to the high monocyte in Group B. streptococcus. It is concluded that there is no significant relation between the type of microorganism and the hematological parameters in neonatal sepsis.

Worldwide, malnutrition is common and is responsible directly or indirectly for about a third of all deaths of children under 5 years of age. Primary malnutrition also continues to occur in developed countries as a result of poverty, parental neglect or poor education. Specific nutritional deficiencies, particularly of iron, remain common in developed countries. Restrictive diets may be iatrogenic as a result of exclusion diets or parental food fads, or may be self-inflicted.This study was done to determine the role of Maximum Thigh Circumference as screening test in early detection of malnutrition . A descriptive cross sectional study was done on children attending the pediatric department , and nutrition department in Tikrit Teaching Hospital from 15th March 2014 to 5th June 2014. The study included 160 Chitdren, their age from (2months -Syears). Each child included in the study was assessed by a prepared questionnaire. Screening done by measuring Weight for age, Height for age, Occipitofrontal Circumference for age, and Mid-arm circumference , and then diagnostic test done by depending on weight for height to confirm diagnosis or exclude malnutrition. The total number of cases 160 case (50% boys and 49o/o girls )r45% from cases are malnourished and 54oh with normal growth .ages range from 2month to 5 years .higher cases of malnutrition were females 57o/o. abofi 19 (47.5oh) of normal children were females who lived in urban area, While 31 (65.9%) of males who lived in rural area were normal nutritional state. among malnourished children there were 24(77.4o/o)r34(80.9o/o) males and females subsequently lived in rural area . Most cases of malnutrition were in bottle feeding 63Yo anil most cases of normal nutritional state were on mixed 24Yo anll solid food 20oA . It found that 3lo/o (from 48cases) of normal males their mothers were on primary school and38Yo(from 39case)of normal females their mothen were on primary school also. 457o (from 33cases) of malnourished males their mothens were illiterate, read and write ,While 507o(from 40 case)of malnourished females their mothem were read and write Anthropometric measures , Mid-Upper arm Circumference(MUAC) is highly sensitive test 917o for detection of malnutrition and Wt/age is specific test 92Yo. Mean llrlaximum Thigh Circumference GVITC) for nomal male:(21+/-3)& for malnourished male :(14+/-3). Mean MTC for normal female zQl+l-2) &for malnourished female :(15+/-3). The sensitivity of MTC is high in females 97o/oand specific in males 817o.
Finally the present study concluded that the using of maximum thigh circumference is a good method to detect early malnourished cases .

Background: Acute kidney injury (previously known as acute renal failure) is a sudden loss in kidney function. There are a number of triggers, including blood and fluid loss from accident, dehydration, burns, or surgery, side effects from drugs, cardiovascular disease, infection, liver failure or severe allergic reaction.
Objective: The aim of the present study was to assess five important factors in patients with AKI (the amount of 8-OHDG, il-6r IL7, Blood Pressure, and Pulses). These factors were surveyed in AI(I patients to compare with healthy controls and find out the correlation between AKI and serum 8- OHDG,ll-6rlJ.7, Blood Pressure, and Pulses levels
Materials & Methods: The study was conducted prospectively between the dates June 2012 and April 2013. Population of the study consists of 41 patients diagnosed with acute kidney injury (AKI) and a control group of 41 healthy people. 8-OHDG, interleukin-6, interleukin-7 and blood pressure levels were evaluated in all subjects.
Results: Serum levels of inflammation markers, IL6 and IL7 were signilicantly increased in
AKI group versus control group. The percent of DNA damage of peripheral btood mononuclear cells was higher in AKI patients (23.24+10.84 ng/mt) compared to healthy controls (830$.S6 nglml) (p<0.001). Pearson correlation analysis showed a significant positive correlation of DNA damage with IL6 and IL7, but not with Sys.BP, Dia.BP, pulses and age.
Conclusion: the results of the present study suggest that 8-OIfdG tevel in Acute kidney injury may be a useful marker of DNA damage also blood &OHdG had significantly positive correlation with IL6 and II-7. Oddative stress may serve as a risk factor for the presence of Acute kidney injury in Iraqi men.

Background: Infertitity is one of the most common female disease and it is defined as the inability of getting pregnant after trying for more than one year, without use of birth control means and while having normal sexual intercourse.
Objective: To know the activity of phosphoextracellular  signal regulated kinase p(ERK1 and 2) in infertile women in serum and its correlation with age.
Patients and Methods: This study was carried out in Tikrit Teaching Hospital in salahdeen Governorate - Iraq, from December 2013 to February 2014. ln this study, forty-six women (25 infertile married women and2l apparently healthy women considered as control); their ages range from 16 t0 39 years, were collected to investigate their p(ERK1 and 2) activity in serum by using enzyme linked immunosorbent  assay (ELISA) technique .
Results: Serum p(ERKI and 2) activity was signilicantly decreased in infertile women, mainly in women more than 25 years of age.
Conclusion:  Serum p(ERKl and 2) activity were significantly less among infertile women than the control group. Women with age more than 25 years had less activity compared to infertile women less than 25 years of age. A significant statistical negative correlation was seen between serum p(ERKl and 2) activity and the age.

The main aim of this study was identification of most common microorganisms associated with vaginitis.
This study was performed between Feb. 2013 and Juan. 2014, involving 215 married women at 15- 49 years who attending TGH and private clinic in Tikrit city; they were examined and taking high vaginal swab. For diagnosis, used Amsel\'s criteria, Gram staining of vaginal discharge, culture and polymerase chain reaction @CR).
Vulvovaginal candidiasis is most common 70(32.6%> woman infected with C. albicans than BV associated G. vaginalis 18(8.4%), in our distinct. Recognize Candida spp. are not always done by culture, with presence of E. coli and S. aureus were 25(11.6oh) and16(7.4o/o) respectively. The most affected age was 2529 year (19.5%). The history of abortion and PTL in those patients was at lst and 3rd trimester of pregnancy. In this study molecular method (PCR) was used to diagnose BV associated G. vaginalis and at the sametime to diagnose Candida spp. PCR is a novel toot with excellent sensitivity and specificity especialy in fastidious IVLO as G. vaginalis. By disc diffusion method showed resistance l00o/o to metronidazole.
We conclude that Candida vaginitis is most common in our distinct. The clue cells and measurement vaginal pH are the most suitable tests of Amsels criteria for prediction of BV associated G.vaginalis. In addition, the use of metronidazole is not always benefit so we need further study of screening and use of newer local antibiotics and disinfectants.