Al-Qadisiyah Medical Journal

Objectives: In the present work, we analyzed the predominant Salmonella typhimurum component outer membrane proteins and lipopolysaccharide (OMPs and LPS) that triggered an immune response in 45 patients with enteric reactive arthritis by assessing the anti-OMPs and anti-LPS antibodies (including IgG. IgM and IgA) by ELISA
Methods: forty-five patients with Reactive arthritis, they were 22(48.89%) males and 23(51.11%) females, the age range was 20 - 40 year with mean (33.6) .All patients were outpatient visitor or hospitalized in city hospital in Baghdad over the period of study .They were diagnosed clinically by consultant rheumatologist, as well as some laboratory tests such as RF, CRP and E.S.R.
The patients should be sero-negative (RF-negative) and fulfill Amor and European Criteria (1), to be included in this study , patients were classified according to disease activity in to three group severe, moderate and mild by using (DAREA score)(2),the majority of patients 19 (42.22%) presented with high disease activity (severe) and 15(33.33%) patients were moderate and the remainder were mild disease group consist of (11) patients (24.44%).Thirty age and sex matched apparently healthy individual, were considered in this study as a control group. Wells were coated with antigens (OMPs and LPS of Salmonella) in coating buffer and anti-OMPs and anti-LPS antibodies were assayed using ELISA technique.
Results: the mean age of patients was (33.6) years and there were 23 females and 22 males with females to male ratio 1.05:1, the majority of patients 19 (42.22%) present with high disease activity (severe) and 15 (33.33%) patients were moderate and the remainder were mild disease group.
Three classes of antibodies to OMPs and LPS antigens were studied by ELISA. Positive responses to OMPs and LPS in serum of patients were detected and the major antigenic target in Salmonella –induced ReA was LPS and the main antibodies were IgG anti-LPS. Also there was no significant difference between severe, moderate and mild among ReA patients.
Conclusion: We concluded that LPS were the main bacterial antigens that triggered enteric ReA in this study, and determining the triggering bacterial components can help elucidate the precise causes of ReA and will contribute to the designing of a specific serological diagnostic method for this arthritis

Compared to teeth with healthy pulps, root filled teeth are considered more susceptible to fracture.
The present study was directed toward improving the effect of using flowable composite with or without polyethylene fiber reinforcement on fracture resistance of the endodontically treated mandibular molars with MOD preparations.
Thirty sound extracted human mandibular molars were randomly assigned to three groups (n=10). All teeth were root filled and MOD cavity preparation were created. Group (1) was restored with a dentine bonding system(DBS: SE Bond) and composite resin( CR).
In group (2), flowable composite resin ( Protect liner F) was used before restoring teeth with CR. In group (3) leno woven ultra high modulus polyethylene ribbon fiber ( Ribbond, Seattle, WA. USA) was inserted into the cavities in a buccal to lingual direction and teeth were then restored with DBS and CR. After finishing and polishing the specimens were stored in 100% humidity at 37C° for 1 day. Compressive loading of the teeth was performed using a universal testing machine at a crosshead speed of 0.5 mm min "' . the mean load necessary to fracture the samples were recorded in newtons (N) and were subjected to analysis of variance (ANOVA) and Tukey test.
The results showed that the used of flowable composite resin under composite restorations had no effect on fracture resistance of root filled molars teeth with MOD preparation . while the used of polyethylene fjtffer under composite restorations in root filled teeth with MOD preparations significantly, increased fracture strength .
Aim:-
To evaluate the effect of using flowable composite with or without ultra high modulus polyethylene fiber reinforcement on fracture resistance of root filled mandibular molars with mesio - occluso-distal(MOD) preparations.

Aim of study:To evaluate the association between C-reactive protein (CRP) and type 2 diabetes mellitus .
Method:The study sample consisted of (65) patients with type 2 diabetes mellitus( 40) men and (25) women. The CRP was measured for all them and compared with (65) persons without DM as a control group well matched with age and sex to the patient group .BMI for patients in both groups were measured . A p-value of <0.05 was regarded as statistically significant .
Result: 40 males and 25 females with type 2 DM with mean age 60.7 years. The increase in CRP was significant ( p value<0.05) in type 2 DM patients who are male with high BMI and increased age while no significant increase in the level of CRP in the control group ( p value > 0.05) .
Conclusion : These result suggest, that there is an association between CRP and type2 diabetes mellitus .

The present study carried out on (249) cases of pregnant women deliver neonates baby with congenital malformations in AL-Zahra hospital for birth and childhood in AL- Najaf city, during the period (1/1/2005 to 31/12/2008). To determine the relationship between congenital malformations, age of pregnant women, neonate's sex and seasonal period during four years (2005, 206, 2007 and 2008). The results related biostatic significant information at (p>0.05) that the high rate of congenital malformations which occurred between (21-33 year) of the maternal ages. Our observations about year months which related to the malformations appearing the June and July in the years (2005, 2006 and 2007) was recorded highest percent of congenital malformations. From another hand, this present study revealed that high rate in female neonates than the male neonates when compared the neonates gander with congenital malformations.

Background The relation between abnormalities in the lumbar spine and low back pain is controversial ,incidental findings might lead to additional testing & the potential for unnecessary intervention.
Object We examined the prevalence of abnormal findings on magnetic resonance imaging (MRI) scans of the lumbar spine in people without back pain.
Patients& Methods We performed MRI examinations on 200 asymptomatic people (130 females &70 males), ages range 20 -60 yrs. We used the following standardized terms to classify the five intervertebral disks in the lumbosacral spine: normal, bulge, protrusion, and extrusion.
Results Thirty two percent of the 200 asymptomatic subjects had normal disks at all levels. Forty eight percent of the subjects had a bulge at least one level, 23 percent had a protrusion, and 2 percent had an extrusion. Forty percent had an abnormality of more than one intervertebral disk. The prevalence of bulges & protrusions increased with age.
Conclusions On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Clinical correlation is essential to determine the importance of disk abnormalities on magnetic resonance images.

This study aimed to assess the effects of allergen immunotherapy (AI) on patients with allergic rhinitis (AR) in Babylon Province. Allergen immunotherapy involved exposing a patient to gradually increasing doses of specific allergens with the intention of decreasing allergic and inflammatory response, ultimately leading to a sustained decrease in allergic symptoms. A build-up phase (once weekly injections for three months) was followed by a maintenance phase (once monthly injections) that generally continued for 3-5 years.
The effects of allergen immunotherapy were assessed at 0 time, 3 months, and 6 months on 45 the patients with positive skin test to house dust mite and pollen as immunotherapy group (IT group) and the effects were compared to 30 patients as control group who remained on pharmacotherapy.
The changes caused by AI were assessed by symptoms and medications (drugs) use scores, measurement of total immunoglobulin E (IgE) and immunoglobulin G ( IgG), and side effects score .
The study showed that the percentage of sensitivity to house dust mite, pollen, and mixed sensitivity (house dust mite and pollen) were 67% , 20%, and 13% from cases respectively.
The mean levels of total IgE was significantly decreased in the IT group as compared to the control group. Also, there was a significant increase in the mean levels of total IgG between the IT and control group (p≤0.05).In addition, the study revealed marked but nonsignificant reduction in symptoms and medications use score in the IT group with the progression of treatment while less reduction in the control group. The study also demonstrated that the IT is a safe procedure and the complications in this study was not significant. The mean score of side-effects was 0.3.

Background : Atrial fibrillation (AF) is a common cardiac arrhythmia and is a major independent risk factor for peripheral thromboembolism mainly strokes. Anticoagulation with vitamin K antagonists is the most effective therapy for stroke prophylaxis in AF.
Objective : To evaluate how well patients with AF were maintained on the recommended oral anticoagulant therapy (OAC) and within the recommended International Normalized Ratio (INR) target in Babylon.
Methods : In this study; 236 patients were included complaining of sustained or paroxysmal AF. They were admitted to medical ward or attended outpatient clinic in Al-Hilla Teaching Hospital in Babylon governorate during the period from 1st Jan. 2008 to 1st Jan. 2010.
At the time of enrollment; INR was done for all patients and previous INR results were requested and reported. Stable therapeutic anticoagulation was defined as two INR values (measured at least two weeks apart) were within or above therapeutic range.
Then patients were classified into different stroke risk groups. Based on these categories; treatment modalities, it's effectiveness and compliance were calculated.
The antithrombotic therapies were considered consistent with guidelines when OAC was prescribed for high and intermediate (subtype A) risk groups and acetyl salicylic acid-aspirin (ASA) was prescribed for intermediate (subtype B) and low risk groups.
The patients on OAC were considered "within target INR range" if INR was within recommended target range in 50% or more of occasions.
Results : A total of 236 patients with AF were studied; age range was 18-86 years, 58.5 % (138/236) of them were males.
38.6% (91/236) of our patients were on recommended treatment according to guidelines recommendations. 55.1% (130/236) of our patients were ideally indicated for OAC therapy and only 43.1% (56/130) of them were on OAC therapy. 35.2% (83/236) of our patients were in high risk group and only 44.6% (37/83) of them were on OAC therapy
Conclusion : There is a clear under-treatment of AF in Babylon even in patients with high stroke risk, and the patients on OAC therapy weren't achieving target INR.

Background: Nocturia (i.e., waking at night to void) is common and disrupts sleep. Traditionally, one nightly episode has been regarded as clinically meaningless.
Objective: To evaluate the bothersome effect of nocturia on health related quality of life (HRQoL) in a group from Al-Diwaniya population.
Patients and methods: In 2006–2008, a survey was made on a random sample of 600 patients aged 18–79 yr who were identified from Al-Diwaniya teaching hospital, proportion was 62% males and 38% were females).
Measurements: bother from nocturia on QoL were examined in relation to self-reported nocturia frequency (using the American Urological Association Symptom Score). Bother from nocturia was assessed on a four-point scale (none, small, moderate, major).
*Dept. Of Surgery, College Of Medicine, Al-Qadissiya University.
**Resident Urologist.
Results and limitations: Degree of bother increased with nocturia frequency (p < 0.01). The most commonly cited degree of bother for those with one, two, and three nightly voids was no bother, small bother, and moderate bother, respectively.
Conclusions: At least two voids per night are bothersome and associated with impaired HRQoL. The majority of people report having bothered when the number of nocturia episodes is two and moderate or major bother when the number is three or more. One void per night does not identify subjects with interference from nocturia and, thus, is not a suitable criterion for clinically relevant nocturia.

This experimental study was designed to evaluate the effectivness of some antimicrobial agents against Leishmania donovani promastigotes (LDP) in vitro. It was performed in College of Medicine in Kufa University during october and november 2008. It included treatment of LDP, cultured in Roswell Park Memorial Institute (RPMI) medium enriched with 10% fetal calf serum (FCS) for 14 days, with azithromycin (6, 12, and 18 µg /ml), trimethoprim-sulfamethoxasol (0.5-9.5 µg/ml), norfloxacin (1 µg /ml ) and meglomin antimoniate (20 µg/ml).The control group contained no antimicrobial with the LDP.
Samples were grouped so that each group (20 samples) treated under standardized conditions with one drug (except the control group) in certain concentration that is within its minimal inhibitory concentration (MIC). Promastigotes were counted during the log phase of the growth curve (at day 8). They were subdivided into motile, sluggish and immotile during the counting process and data from the drug-treated groups were compared with that of the control group.
The results showed that mean count of motile LDP at day 8 of cultivation in the control group was ( 129.2×104 )LDP/ml, while mean counts of motile LDP in the treated groups were as follows: (20.4×104, 9.2×104, 5.6×104) LDP/ml for azithromycin group, ( 10.64×104 ) LDP/ml for trimethoprim-sulfamethoxasol group, (1.6 ×104) LDP/ml for norfloxacin group and (4×104) LDP/ml for meglomin antimoniate group. There was a significant reduction in motile LDP count in all treated groups compared to the control group (p <0.05), though it is insignificant in comparison to meglumine group (p >0.05). According to these data, it is clear that these antimicrobials may be effective enough as an experimental trial on infected mice then to be used in vivo as antileishmanial agents in the future.

Fracture of patella comprises approximately 1% of all skeletal injuries. We managed 32 patients with closed transverse patellar fractures in a prospective study during the period between November 2006 and December 2008(with mean follow up one year) at al Sader, al Hakeem and al Manathera hospitals .All cases were treated by open reduction and internal fixation. There were 16 cases randomly fixed by modified tension band and longitudinal Kirschner wires (MTB&LKW) method and 16 randomly fixed by circumferential cerculage wire (CCW) in patients' age (20-50 years) .The results were assessed by a Lysholm & Gillquist score. Regarding (MTB&LKW) method, the outcome was excellent in 50%, good in 37, 5 %, and fair in 12,5%case but the outcome was excellent in31,75%,good in25%, fair in 25% and poor in18,25 % with (CCW) method. We concluded that the (MTB&LKW) fixation method is superior to (CCW) method in that it shortens the average time for union and allowed less fracture displacement than did other method.
The aim of the study is to determine whether modified tension band fixation method results in better outcomes compared with those after circumferential Cerculage wire fixation method in the treatment of closed patellar fractures.

Background :
Somatization disorder is multiple medically unexplained symptoms of long duration& involve multiple organ systems.
Objectives To study the prevalence of somatization disorder among patients of PHC. Centers and the role of the various socio-demographic factors also demonstrate the presentation & clinical pattern of somatization disorder.
Methods Out of 678 patients who were selected randomly from two of primary health care centers in Diwaniya city over a period from the first of October 2009 to 31th December 2009. These patients were interviewed using the International Diagnostic checklist for ICD-10 somatization disorder.
Results The study reveals that 14.6% of the patients have Somatization Disorder. and it is most common among (46-55) years age group(19.1%), females(19.7%), divorced(27.8%), illiterate(24.3%), low family income(21.2%) & unemployed (17.0%)patients.
Somatization Disorder. was least common among age group(15-25) years(4.5%), male(8.1%), married(12%), highly educated (7.3%), high family income(6.7%) & employed(11.8%) patients.
The most common presentation of somatization disorder. was pain in limbs, extremities or joints( 81.8%) .
Conclusions :
Somatization Disorder. is relatively common in PHC. visitors & this represent a big burden on health institutions if remain undiagnosed for long period

Background: Diabetes Mellitus (DM) is a clinical syndrome characterized by chronic hyperglycemia and have multifactorial effects on immunity which increase the liability for infections with higher risk of lower respiratory tract infections including pulmonary tuberculosis (PTB).

Objective: To assess the effects of hyperglycemia in DM on the clinical, bacteriological and radiological presentations of pulmonary tuberculosis.

Methods: This study enrolled 25 tuberculous patients out of 310 diabetic patients who attend to the out-patient clinic of DM at Al-Diwaniya Teaching Hospital, they were studied during the period from 1st of October 2009 to 31st of March 2010.

Results: This study revealed that male to female ratio was 4:1. 16% of the patients were type 1 DM, 56% were diabetic ،ـ10 years, 12% had fasting blood sugar (FBS) ،ـ6.9 mmol/l, 84% had HbA1c level ،ف7.0%, 24% had positive history of pulmonary tuberculosis and 76% had positive sputum smear for acid fast bacilli (AFB). Multiple lobe involvement, cavitary lesions, lower lung field involvement and pleural effusion had been diagnosed in 64%, 60%, 32% and 16% of the sample respectively.

Conclusions: This study revealed that DM affects the clinical, bacteriological and radiological picture of PTB. Diabetic patients have a higher risk for recurrence of PTB.

The tibia is the major bone of the lower leg, commonly referred to as the shin bone. Tibia fractures can occur from many types of injuries.
Our study is to evaluate patients with different types of fracture shaft tibia. 53 patients were admitted to Al Hakim, Al Sadder & Al Forat hospitals, 39 males &14 females their ages range from 12-55 years were evaluated for different types of fracture shaft tibia in regard to shape of fracture, type of fracture whether open or close, cause of fracture, severity of injury, method of treatment, the complication of treatment, & the time of union & patient return to job.
We found that closed fractures were more than open fractures & that healing of closed fractures in those treated operatively was earlier than those treated by cast but complication rate was less in casted group.
So we recommend using cast in treatment of stable, closed fracture shaft tibia& that operative treatment is to be used for unstable, or for open fractures with sever soft tissue injury.
Aim of study:
This study is to evaluate patients wit fractures of shaft of tibia in regard to shape of fractures, type of fractures whether open or closed, cause of fractures, severity of injury whether high or low energy trauma, method of treatment, the complications of fracture & its treatment & time of union & patient return to job.

Abstract
Many studies have been conducted regarding using low power laser in treating patients suffering from tinnitus. The aim of this study is to evaluate the effectiveness of 2Watt laser irradiation in the treatment of tinnitus(subjective tinnitus of sensor- neural in origin).
A new procedure is used in this study by selecting 19 patients suffering from tinnitus who have not responded to medical therapy for a long period of time. Those treated by low level laser therapy have the irradiation toward cochlea,27 ears in 19 patients with unilateral or bilateral tinnitus , 2 Watt laser with wavelength of 790-805 nm is applied toward cochlea for 7.5 minuets three times per week .
A questionnaire is administered by asking patients to score their symptoms on a percentage scale before and after laser irradiation. A decrease of one scale regarding the loudness, duration of tinnitus and degree of annoyance of tinnitus is accepted to represent any improvement.
The results are estimated by the change of loudness, duration and degree of annoyance due to tinnitus.57.8%of patients have demonstrated improvement in their tinnitus. It is concluded that laser therapy seemed to be worth trying on patients with intractable tinnitus.

Purpose: To examine the dissemination of extended spectrum ß-lactamase (ESBL) producing isolates of Klebseilla pneumoniae obtained from patients with significant bacteriuria.
Methods: ESBL and multiantibiotic resistance were studied in a total of 25 isolates of K. pneumoniae.
Results: all isolates found resistance to at least five of the antibiotics used in this study. All the isolates were found sensitive to the antibiotic imipenem. 5 (22.7%) of these isolates were ESBL producing. The ESBL producing isolates were more resistant to antibiotics than non-ESBL isolates. The ESBL activity could be experimentally transferred to recipient Escherichia coli MM294.
Conclusions: present study has found the occurrence of ESBL producing K. pneumoniae isolates in Najaf hospitals. Test for the detection of ESBL producing bacterial isolates should be carried out in all diagnostic laboratories routinely and the therapeutic use of all the third generation cephalosporins should be avoided against bacterial isolates that appear resistant to any third generation antibiotic.

Aim
Use of cage and bone graft for decompression and fixation cervical spine

Methods
Fourty patients between june2004 _ june 2006 , evaluated by physical and neurological examination with radiograby by x
Ray and MRI . the treated by anterior disectomy and replaced by cage and bone graft.

Result
Regarding the site of disc prolapsed (10%) between C4 -5(65%) between C5 -6 and (25%) between C6-7 .
37 patients treated disectomy by and bone graft while two
Patient treated by corpectopmy of C5,6 body
The complete recovery presented in 80% , incomplete recovery in 7,5% while no any improvement in 2,5%

Conclusion
Immediate stability with good clinical improvement and no graft morbidity are the advantage of this implant compared to
conventional interbody grafting techniques .

Background: Epidural analgesia for providing Painless normal vaginal deliveries has been developed over the last 20 years,epidural local anaesthetics was the only available option. However, cetain drugs were added with the local anaesthetics to improves the quality of analgesia.
Aims : to ascertain the efficiency of fentanyl added to the epidural local anaesthetics in comparison with the use of an epidural local anaesthetics alone.
Patient and methods : This study was carried out on 30 parturients prepared for painless normal vaginal delivery under epidural analgesia in Al-khuder general hospital.
All patients subjects according to American society of Anaesthesiologist (ASA) classification were grade 1 between 20-40 of age with length taller than 160 cm.Subjects were allocated into two groups (15 patients in each group):
Group A (n=15) received through an epidural catheter 8 ml lidocaine 0.75%+ 2ml normal saline for the first main dose and subsequent top up doses.
Group B (n=15) received through an epidural catheter 8ml lidocaine o.75% + 20 microgram fentanyl diluted with normal saline to a total 2 ml volume for the first main dose and subsequent top up doses.
Onset of action of local anaesthetic , the interval from initial bolus dose to the maternal request for additional analgesia , the number of top up doses and the neonatal condition in both groups were recorded.
Results : the group B is associated with shorter onset of action , longer interval from initial bolus dose to the maternal request for additional dose and a lesser number of top up doses than group A.
The effect on neonatal condition manifested by APGAR score at 5 minute after delivery is similar in both groups.
conclusions : 20 microgram of fentanyl added to the usual dose of local anaesthetic epidurally is safe , effective and much better than the use of epidural local anaesthetic alone.

To calculate the risk of developing respiratory disorders among workers in Diwaniya, three occupational settings were included and a retrospective cohort studies were applied in two of them, while a case control study was applied in the third.
Among workers exposed to air pollution by sand and cement in construction settings the relative risk was 3 times the risk among non exposed, the attributable risk was 12 more, and the attributable risk percent was 66.67%.
Among workers exposed to air pollution by particulates of carbon and talc in rubber industry, the risks were: 6.67 times, 56.66 more, and 85.01% respectively. While among workers exposed to dust of cotton in textile factory the odd ratio was 12 times that of those not exposed.
More supervision and revitalization of enactments related to work is needed and proper preventive health measures are to be applied for each setting.

A total of 221 stool samples were collected from children suffering from watery diarrhea, less than 15 years old of both genders whom admitted to the Maternity and Children Teaching Hospital in Al- Diwaniya Province, In addition to that, 27 water samples were also collected from three different loci of AL- Diwaniya River, at the period of October 2008 to June 2009, in order to evaluate the routine laboratory diagnostic procedures in the diagnosis the multi-serogroups or serotype of Vibrio cholerae strains and compared them with molecular technique as Polymerase chain reaction (PCR).
Vibrio cholerae has been isolated and identified by using culturing method in addition to biochemical tests, API 20E diagnostic kit. Serotyping by using polyvalent Vibrio cholerae, O1antisera, and monovalent Ogawa and Inaba revealed that the most of clinical V. cholerae were of serogroup O1, while all the V. cholerae isolated from surface water of AL- Diwanyia river was Non-O1 serogroup. PCR technique was used to detect ompW gene encoding to outer membrane protein of V. cholerae. Based on the PCR results, the rate of Vibrio cholerae isolation from stool samples was 5.9%. PCR results showed that there were high specificity (100%, 100%, 97% and 86%) in detection of Vibrio cholerae strains versus each of cultural, biochemical, API 20E system and serological tests, respectively.

This study was designed to investigate antifungal susceptibility and cross resistance of C. albicans isolates toward four antifungal drugs; Amphotericin B, nystatin, fluconazole and ketoconazole. The study groups included 208 patients( 108 women and 100 children) who attented the Al-Suwayra Hospital/ Kut Province during the period from December 2008 to April 2009. Patients groups were represented by women who were complaining of vaginal discharge and itching and children who were complaining of oral thrush and infected with different type of disease include upper and lower respiratory tract infection, gastroenteritis, kala-azar and septicemia. The study showed that the infection percentage of vaginal candidiasis was 35.1% while oral thrush was 70%. The yeast isolates in two groups were C. albicans (76.8%), C. krusei (1.85%), C. tropicalis (5.5%), C. glabrata (11.1%), C. dublinances (0.9%), Trichosporon (1.85%) and Cryptococcus neoformans (1.85%). The activity of certain antifungal agents were tested against C. albicans isolates by using minimal inhibitory concentration (MICs). The results of range of MICs for amphotericin B was ( 8-128µg/ml), ketoconazole (0.5-4µg/ml), fluconazole (8-64µg/ml), Nystatin (0.03-2µg/ml). The MICs of amphotericin B to the isolate that mutant to Nystatin tended to rise in parallel from (0.5-1μg/ml) to (4-16μg/ml). There was no correlation between MICs of these strains with fluconazole and ketoconazole. In addition, The MICs of ketoconazole to the isolates that mutant to fluconazole tended to rise in parallel from (0.5-2μg/ml) to (1-8μg/ml). There was no correlation between MICs of these strains with Nystatin and amphotericin B MICs. All the MICs values of the mutant strain return to the original values after remove the drug effect except the Nystatin . The MICs value for the isolate mutant to Nystatin dropped from the range (600-1200μg/ml) to (200-800μg/ml) but not returned to the original range (64-128μg/ml).

Background : Due to the randomly uses of antibiotics at the last decades against pathogenic microbes and the difficulties of treatment and recovery of burns and wounds infections especially in the hospitalized patients , an attention have been awarded to find an alternative medicine such the uses of as a medical plants preparations or natural materials to minimize the side effects that may resulted from the antibiotics therapy .
Aim : If study the effects in vitro& in vivo of the natural material ( propolis = bees wax) and the medicinal plant ( black cumin) as alone or in their combination against some pathogenic isolates of burns and wounds contamination.
Materials & methods : Burns and wounds swabs were collected from hosted in patients in Al-Dwiania teaching hospital in order to isolate and identified the causative agents of burns and wounds infections using the routine culture methods .The effect of oily extract of black cumin seeds and alcoholic extract of propolis using disk diffusion and dilution methods of antibiotics susceptibly test were done against different isolate of bacterial causes of burns and wounds infections .The lethal dose (LD50) for prepared extracts was calculated .The efficacy of these extracts ( propolis & black cumin ) were also tested as in vivo an ointment preparation (9%) against experimentally infected skin of mice with bacterial isolates .
Results : The main medical active ingredients in black cumin's extract were flavonoids , phenols , resins , coumarins and glycosides, while in propolis were phenols , resins and flavonoids .S. aureus was highly ( P<0.05) susceptible to the action of each extract alone or in both , followed by Strep. pyogenes , E. coli and P. aeruginosa than the ointment of gentamcin as a control .The prapared ointment (9%) showed high qualification to treat such experimentally wounds in mice (8-9 days ) in comparison with control group (15-19 days ) .
Conclusions & recommendations: The prepared mixture ointment from propolis and black cumin revealed a high efficacy (P<0.05) in treatment of wounds of laboratory infected mice with tested isolates and with 100 toxicity than drug control (Gentamicine) , So , the use of these medicinal and natural material in treatment can be recommended after a widely and deeply studies on voluntaries to document and establish the usage of this ointment .

A total of 480 fecal samples were collected from children (less than 3 years old) , of both sexes suffering from diarrhea who admitted to The Teaching Hospital of Maternity and Pediatrics in Al- Diwaniya governorate. Salmonella spp. were isolated and identified using bacterial culturing on selective media, in addition to, biochemical and Mini API 20E. Polymerase chain reaction (PCR) was used to detect fimA gene encoding for biosynthesis of fimA of Salmonella spp. The results revealed that the rate of Salmonella isolates in fecal samples of patients were (38/480) 7.9% using cultural and MiniAPI20 E, when the PCR technique was used to detect the presence of fimA gene, 34 Salmonella isolates belong to Salmonella spp. appeared to contain this gene since DNA amplification showed one distinct band (size 85 bp) when electrophorised on agarose gel. The results of this study revealed that the PCR technique had a high specifity (100%) in detection of Salmonella spp. in comparison to cultural and biochemical and Mini API20E tests.