The Medical Journal of Tikrit University

Background Long QT syndrome (LQTS) is a heart rhythm disorder that can potentially cause fast, chaotic heart beats. These rapid heartbeats may trigger a sudden fainting spell or seizure. In some cases, your heart may beat erratically for so long that it can cause sudden death.
The aim of study is to evaluate the effects of halothane and isoflurane on QT interval in patients underwent hemorrhoidectomy.
patients and methods ECG were recorded in operative theater at al-shurgat general hospital just before surgical operations and directly after end of operation , 37 young , healthy patients were participated in this study 29 male and 8 female (n=17)received halothane (20) received isoflurane.
Results: The mean and standard deviation of participants age and duration of ] operation was considerably higher among those who received halothane in | comparison to isoflurane and differences was statistically significant and the mean of age was 29.35+5.958 years with halothane and 24.55+4.893 years with isoflurane , | (p-value 0.011) and regarding the mean of duration of operation was 19.47 +3.243 minutes with halothane and 16.75+3.240 minutes with isoflurane use ,(p-value 0.023) | Conclusions the present study conclude that maintenance of anesthesia with halothane might prolong the QT-interval and did not result in arrhythmias while , with isoflurane was not associated ~ with alterations in the QT-interval and induced no changes in cardiac rhythm

Background: Oxidative stress is associated with the development of several disorders including cardiovascular disease and cancer. Among conditions known to influence oxidative stress, the use of oral contraception (OC) in women has been a matter of ongoing discussion. The aim of the study report to evaluate the impact of oral contraceptive formulation containing 30 mg oestrogen (ethyloestradiol) and 1 mg progestin (norethisterone acetate) on lipid peroxidation, GPx, SOD, and catalase levels.
Patients & Methods: The present study was conducted in Family planning in Salahalddin Teaching Hospital in Tikrit province during the period from Feb 2016 until March 2017, Serum glutathione peroxidase (GPx) and , malondialdehyde (MDA), Super oxide dismutase (SOD), and catalase levels were estimated in 50 women who were using oral contraceptives for at least 1 year. Fifty- contraceptive users participated in the study as a control group. They were drawn from the same population and matched for age with the contraceptive-users group.
Results: The serum level of MDA, and GPx was significantly higher in women were using oral contraceptive than control group(11.872 ± 1.13 1..tM vs. 9.148 ± 1.179'11M respectively, 45.140 U/g Hb +2.265 vs. 29.86 U/g Hb ±2.31 ) respectively . On the other hand the serum SOD, catalase values in women using oral contraceptives were significantly lower than control group.( 2.72 U/L ± 0.479 vs. 3.5599 U/L ± 0.496 , 22.452 Kim! ± 2.045 vs. 26.370 K/ml ± 1.523 ) respectively.
Conclusion: Oral contraceptive pills showed a significant decreasing effect on the antioxidant status of its users .Routine monitoring of the antioxidant status of women on oral contraceptive is recommended

Background: Measles is a highly contagious viral infection affect mainly children, the main symptoms and signs are fever, cough, runny nose and red eyes (conjunctivitis) Koplik's spots and red flat rash.
Aim and Objective: To describe the trends and distributions of measles in the population of Nineveh governorate in Mosul city and to estimate the frequency of clinical features of measles among study population, and to estimate the difference in a rate of infection according to sex and age between males and females , also to estimate the ratio of vaccinated patients with measles to the unvaccinated.
Patients and Methods: during the period between 1st February to the 30t1' of April 2015 we made a case series study of 84 patients collected of different ages and sexes admitted to Al-Shefaa Hospital in Mosul city.
Results : The distribution of measles in Nineveh governorate was twice in males than females and regarding to the age, the highest rate of infection was found in children within 1-5 years and the least rate of infection was found in adults whose age between 15-45 years (3.6%). Conclusion: Measles affect males more than females, Measles affect the age between 1-5 years most of the patients infected by Measles having no history of vaccination, the complications of Measles are more severe in Adults.

Background: Doppler study of the placental vessles has an important role in detection of impaired placental development and its complications. Amniotic fluid volume is an important parameter of placental function. Changes in umbilical artery doppler parameters in cases with decreasing amount of fluid vnIntne in third pregnancy without cause may be due to placental malfunction.
Objective: To evaluate the umbilical doppler parameters including Pulsatility Index (PI), Resistive Index (RI) and Systolic to Diastolic ratio (S/D) in full term pregnancies with normal amniotic fluid volume (amniotic fluid index of 8-25 cm),borderline amniotic fluid volume(5.1-8 cm) and those with oligohydramnios ( amniotic fluid volume less than 5 cm) to exclude placental malfunction in those with lower than normal fluid volume.
Patients & Methods: One hundred seventeen full terms pregnant were evaluated between February 2014 and June 2016, at Azadi teaching hospital /Kirkuk city and outpatient clinic. Three groups were identified according to their amniotic fluid volume: decreased, borderline and normal amniotic fluid volume, the groups were labeled as (group A, B and C) respectively. Umbilical arterial doppler parameters (including RI, PI and S/D) were measured in all patients and the results were compared among the three groups.
Results: There was no statistically significant difference (P=0.29) in the mean RI values among the groups, as the mean RI value was 0.61 for group A, 0.59 for group B and 0.59 for group C. The mean PI values of the three groups were not significantly different (P=0.75), neither the mean S/D values (P=0.77); mean PI value was 1.01 for group A, 0.98 for group B, and 0.97 for group C; S/D values were as the following 2.59 for group A, 2.51 for group B and 2.55 for group C. The same analysis was done in subgroups divided according to the maternal age, the older age group 34-40 years revealed significantly (P=0.049) higher mean S/D value in group C (0.50) compared to both group B (0.39) and group A (0.26); and significantly (P=0.05) higher mean RI value for group C (0.64) compared to group B (0.60) possibly due the smaller gestation age in group C. Conclusion: There is no correlation between umbilical artery velocity waveform parameters and amniotic fluid volume in uncomplicated third trimester pregnancy, so routine use of doppler in such cases is not recommended as there was no underlying placental dysfunction

Background : Prior studies have supported that waist circumference (WC) correlates with abdominal (central) obesity and values higher than normal are associated with increased prevalence of type two diabetes mellitus (T2DM) .
Objective: To evaluate the association of waist circumference (WC) with increased prevalence of (T2DM) among population in Kirkuk city.
Research design and methods: A cross-sectional survey was conducted of 776 men and women 40-70 years of age from Kirkuk city. The relationship between (WC) and blood glucose was assessed .The(WC) was measured in centimeter , together with other data designed in the data sheet for this study , (T2DM) people were identified and recorded .Patients who had Diabetes Mellitus and coexistence of any other serious illness were excluded from the study.
Results: (WC) was positively correlated with blood glucose .out of 776 participants , 221(28.5%) had increased (WC) ,this included 59 (26.7%) (T2DM) ,compared with 555 (71.5%) participants with normal (WC),this included32 (5.8%) diabetics increasing (WC) were significantly associated with increased prevalence of (T2DM) in the Kirkuk populations(P < 0.05).
Conclusions: Increasing waist circumference was significantly associated with increased prevalence of (T2DM) ,Substantial reduction in diabetes in men and women is achievable if the (WC) is decreased in these populations.

Background: Congenital heart diseases are an important causes of morbidity & mortality of children. Pulse oximetry is used routinely in neonatal intensive care and emergency units. This study was aimed to evaluate the results of oxygen saturation measured by pulse oximetry with the purpose of use it to detect congenital heart diseases in children as it is readily available, relatively cheap and easily done.
Patients and Method: This is a cross- sectional, comparative study. It was done at al-Batool Teaching Hospital for Maternity & Children- Diyala province/ Iraq from Sept 2011 — Mar 2012. Children who were suspected to have congenital heart disease was examined by echocardiography and pulse oximetry together, a cut- off value of oxygen saturation (Spo2) measured by pulse oximetry below 95% was considered low and compared to echocardiography results. Sensitivity, specificity, false positive rate, false negative rate, predictive values, & accuracy rate were calculated.
Results: A ninety five children had enrolled, 45 ( 47%) of them had congenital heart diseases and 50 child ( 53%) had normal echocardiography results. Pulse oximetry showed a decreased Spo2 in 13 of 45 children with CHD ( sensitivity = 29 %) and it was normal in 44 from 50 normal children ( specificity = 88 %). The results were rather similar after comparing the results of Spo2 of acyanotic CHD children versus the normal children. Spo2 of cyanotic CHD of children to the normal group showed high sensitivity and specificity, 100 % & 88 %, respectively.
Conclusion: Pulse oximetry was found to be specific & sensitive tool to detect cyanotic defects, so routine pulse oximetry may detect a child who might not have been detected otherwise. In acyanotic subtypes, pulse oximetry had a limited role in detection of the defect & in spite of good specificity to exclude them in normal babies

Background: Diabetes Mellitus presents a major challenge to healthcare systems around the world. One of the outcomes of diabetes is oxidative stress that is caused by the effect of hyperglycemia. Recent studies indicate that, oxidative agents in diabetes result in many
complications such as cardiovascular disease, retinopathy and neuropathy.
Aim of the study: This study was designed to evaluate the effect of Moringa oleifera (MOE), in Streptozotocin (STZ)-induced diabetes in wistar rats.
Methods: The rats were randomly divided into three groups of 10 animals each: Group I, healthy control; Group II, diabetics; Group III, diabetics treated with MOE (100 mg/ kg) for12 weeks . Diabetes was induced by a single intra-peritoneal injection of Streptozotocin (STZ, 65 mg/kg).Finally, blood samples were collected and analyzed for glucose and interleukin-1(IL-1), interleukin-2(IL-2), and tumor necrosis factor a (TNF-a).
Results; result revealed that, oral administration of MO extract caused a significant decrease in serum glucose IL-1, and TNF-a levels(183± 41.10mg/d1), (25.7 + 1.5 pg/ml), (10.7 ± 2.0pg/mL)respectively , whereas increased in IL-2(5.0 ± 1.92 U/mL) in diabetic rats treated with MO extract when compared to levels of diabetic and control groups (298.2 ± 8.09mg/d1), (97.24 ± 3.21pg/m1), (13.4 ± 2.21pg/mL),and (4.08± 1.17U/mL) respectively.
Conclusions: It appears that, Moringa olifera extract had both antihyperglycemic and decreased the activity of IL-1, and TNF-a , and increased IL-2 on STZ-induced diabetic rats. Further studies are needed to determine its protective effects on the other diabetes complications.

Background: Congestive heart failure CHF is a complex clinical syndrome characterized by dyspnea, fatigue, and signs of volume overload, which may include peripheral edema and pulmonary rules.
Aim: The goal of the current study was to evaluate the alterations in different biochemical parameters including leptin, Adiponectin, ghrelin, Ceruloplasmin , concentration in patients with congestive heart failure.
Patients and Methods: The total of 60 patients - 19 Males and 11 Females - were enrolled in this study, 30 of them with congestive heart failure ( study group ) and 30 with apparently healthy subjects - 13 Males and 17 Females - control group .
Results: The levels of leptin, ceruloplasmin, copper, and sialic acid , TNF-a, and CRP were significantly elevated in patients group, while adiponectin , ghrelin, Vitamin C and E were significantly lower in patients group compared to control group, there was positive correlation between leptin with adiponectin and ghrelin , adiponectin with ghrelin, Vitamin C with E ,ceruloplasmin with copper in congestive heart failure patients.
Conclusions: Serum leptin, ghrelin and adiponectin are biomarkers for and correlated to CHF not only in the role they might play in the pathogenesis of the disease but also in their severity. Serum ceruloplasmin, copper, and prognostic indicators in patients with CHF.

Background: knowledge of the normal growth and development of children is essential for preventing and detecting disease by recognizing overt deviation from normal pattern. Various genetic syndromes, birth defect and acquired diseases are characteristic by abnormal shape and size of the chest and site of nipple. These abnormalities may be evident in longitudinal measurements as short chest, or in horizontal measurement as deviations in chest circumference.Aim of the study: to test and make internipple distance, sternum length, torso length as a part of growth measures in evaluation and diagnosis of growth assessment in newborn infants.
Patients & methods: A cross sectional study involve 732 newborns consist of 708 normal newborns: 570term (298 male and 272 female), 112 preterm (male 42 and female 70) and 26 post-term (male 19 and 7 female); while congenital anomalies were observed in 24 newborns: 2lterm newborn (male 6 and female 15) and 3preterm male between gestational ages 27 and 43 weeks and weighed from 700 gram — 5 kg delivered or attended to Salahaddin general hospital during period from 15thMay 2017 to 15th September 2017. Weight, length, occipitofrontal circumference , chest circumference , torso length, internipple distance and sternum length were measured for each newborns.
Results: There was a difference found between male and female. The mean internipple distance for term newborns (8.7 cm) in male and( 8.6 cm) in female while in per-term (6.16 cm) and for post-term (9.4 cm) . The mean internipple index in our study was being 26% as a larger chest circumference decreases the internipple index. The mean of sternum length in term male (7.8 cm) and in term female (8.7 cm) while in pre-term (6.1cm) and in post-term (8.9 cm) the sternum length in male is shorter than in female . The sternal index is about ( 0.47) in our study. The mean of torso length in term male (20 cm) and in term female (19.8 cm) while in pre-term (17 cm) and in post-term (22.8 cm). The internipple distance in screening test was sensitive and specific for males (81.2% and 84.3%) and only specific for female 90 % , while sternum length is sensitive and specific for females (89 % and 94.4 %) and males(70% and 91.8% ) as well as torso length which is specific and sensitive in both sex.
Conclusions: internipple distance, sternum length and torso length varies with , gestational age and increase as the pregnancy continue. A internipple distance of 9.6 cm or an internipple index of 28.2% in the neonatal period indicates widely spaced nipples. and the sternum is considered short when sternal-torso index is below (0.33)

Background: "Coronary heart disease" (CHD), "also known as coronary artery disease is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart". "Coronary heart disease (CHD) is the most common form of heart disease and the single most important cause of premature death in Europe, the Baltic states, Russia, North and South America, Australia and New Zealand. By 2020 it is estimated that it will be the major cause of death in all regions of the world".
Aims of study (objectives): The aim of this study is to identify the attitude of Kirkuk city people toward CHD, determining their level of knowledge about its symptoms and categorize its risk factors.
Patients & methods: This is a cross sectional study done in Kirkuk city based on direct face to face interviews using a questionnaire. This questionnaire was developed by the lead researcher to identify people's knowledge, attitude and practices toward CHD. A total of 375 sample of male and female of different educational level and of age starting from 15 year and above were selected randomly from Puplic Kirkuk hospital, Azadi hospital attainders, patients and visitors. A cross sectional study depend on direct face to face interviews using a questionnaire, several testes were used to determine the presence of selected factors and what can affect people's knowledge (example: the symptoms of CHD), attitude (by Having CHD risk factor or not) and the practices (what would be the patients choice when he have the attack) of the CHD.
Results: of the 375 people sampled, 235 were male and 140 were female. Smoking, hypertension and high blood cholesterol; were the most popular risk factors that most of the patients mentioned it spontaneously. The educational level significantly associated with knowledge and attitude for CHD. Emergency management had significant value. The degree of knowledge about the risk factor of coronary heart disease in comparative way between male and female in Kirkuk city was significant .Knowledge of people about the practice of coronary heart disease is 72%; of this 71% male and 78% female. Percent of knowledge about the practices of coronary heart disease in Kirkuk city by gender was not significant.
Conclusions and recommendations: Findings from this study suggest that middle and older aged people in Kirkuk city have only limited knowledge regarding CHD risk factors. Therefore, people living in this City may need even more attention and a resource regarding CHD symptoms, risk factors and treatment options as it is a common cause of mortality

Background: Health status among the orphans in social institute is of critical importance because they represent significant part of the community, as well as their surrounding circumstances differ from the others as all know.
aim of the study to assess the health status among the orphans in social institute in Tikrit city Patients and Methods: Across sectional study was conducted on 40 residents(boys and girls)at average age between (3-18)years by using a questionnaire form. A period between the beginning of February to the end of April of 2014.A questionnaire form was designed to the o study including information about family history , any health problem ,physical examination regarding weight ,height ,body mass index(BMI).
The Results: We found that normal BMI is the commonest among them 47%. The proportion of high BMI increase with the age instead that the proportion of low BMI decrease with age. 31 % of the students between 7 —11 years whereas only 39 %of those between 12-18 years were overweight. The normal BMI are equal among both females and males. Psychological problems were prominent among orphans and had become the most important contributor of lower life quality. Of 40 orphans provided credible information on the vital status of their parents; 50% had lost their father, 30% their mother and 20% had lost both parents ,About the information that was collected from them about if they have had infected with any of these communicable diseases throughout the period of staying there , we found 38% had measles, 31%had mump,18%had rubella,4%typhoid fever .Also we found high percentage (47%) of orphans had unknown history of immunization .On examination (6%)were anemic ,no jaundice, with(8%)have gross anomalies of amputated arm ,amputated arm with speech difficulty and mongolism . As well we found (17%)who were neurologically abnormal (mentally Retarded) and 26% were psychologically upset. a community-based prevention ,care approach and support from rich people should be the cornerstone of the plan for improvement .
Conclusion: Orphan children had normal BMI and their age (12-18) years about 47% for each. 50% of orphan children lost their parents. Measles is a frequent infectious disease among orphan children. High percentage (47%) of orphans had unknown history of immunization.

Background : Meatal stenosis is a condition is occurred in 8% to 9% of male child after neonatal circumcision , Many theories described the etiology of development of meatal stenosis,those are either sever meatal inflammation or due to meatal devascularization caused by cutting of frenular artery during circumcision or due to meatal ammonitis , meatal stenosis dose not become apparent till the child is toilet trained, Dysurea , frequency , terminal heamaturia and incontinence are the leading symptoms to discover meatal stenosis, the condition rarely cause a change in the upper urinary tracts. Meatal stenosis is treated either by surgical meatoplasty or periodic dilatation.
Aims: To evaluate the symptomatic improvement in children with urethral meatal stenosis after surgical meatoplasty and compare it with conservative periodic meatal dilatation with hydrocortisone cream.
Patients and method: 23 child with variable degree of meatal stenosis their age were between 2.5 years to 5 years examined in private clinic for their symptoms, undergone complete evaluation including physical examination, laboratory urine analysis , ultrasounic examination for assessment of the bladder and upper urinary tract , and biochemical tests. The 23 patients were divided into 2 group A (12 child) and group B (11 child).
Group A were treated by weekly dilatation using sound metal dilator size 10/12 French , for 4 weeks, Also hydrocortisone 2.5% cream for 3 days implicated to the meatus following each dilatation session.
Group B was treated by surgical meatoplasty (1)
Results: Two month after the procedures all patients in group A , B were re examined: In group A 10 patients (83.3 eYo) developed re stenosis and just 2patients (16.6%) still had adequate urethral meatal opening. In group B 10 patients (90.9%) had good symptomatic improvement and adequate urethral opening, just one( 9%) patient still has obstructive urethral symptom .
Conclusions: Surgical meatoplasty should be considered other than conservative meatal dilatation in definitive treatment of meatal stenosis in children.

Background: smoking is the most common problem that invasion the schools and affect the students. Depending on the several studies and reports, there is a high prevalence smoking between school students.

Aims of this study: to estimate the prevalence of smoker students in preparatory schools in AL- Hamdaniya district with some variables.

Patients and Methods: A descriptive study was applied to estimate the prevalence of smoker students in preparatory schools in AL- Hamdaniya and find the effect of smoking by other variable. The study starts from 10st of March 2012 up to the 25 May 2012. Four preparatory schools in AL- Hamdaniya district, the tools consist variably of age, gender, marital status, residence of smoking and type of style. Descriptive statistical analysis is used of frequency.

Results: The study indicate that there increase in number of student that use mixed type of smoking cigarettes and Hubble babble and students who smoke less than 10 cigarettes are more than other quantity.

Recommendation: The study emphasis on the teacher role in health education especially on identifying the risk of cigarette smoking and relating to the disease, Issuing poster related to the dangerous of tobacco and demonstration of disease related on.