Al-Qadisiyah Medical Journal

Abstract
This study is conducted on a group of patients with suppurative Otitis media from E.N.T. clinic in Al- Diwaniya Teaching Hospital during January to August 2010.
A total number of (55) individuals of both sexes , as patients with suppurative otitis media , consisting of (25) males and (30)females.The age of patients range from(1-60)years .
Samples (ear swab) are taken before treatment .The collected sample is processed for bacterial isolation , identification and antibiotic sensitivity test are assessed for each isolate.
positive results of bacterial culture are (52) (94.54%) of ear swab samples from supurative Otitis media .Gram negative bacteria are more prevalent (29:50)(56%) compared with Gram positive which constitutes (19:50)(44%).
As Gram negative Pseudomonas aeruginosa is the most common bacterial species isolated from patients with otitis media(30%), Proteus vulgaris (16%) ,other gram negative bacteria species (12%) . while Gram positive are Staphylococcus aureus (38%) and Staphylococcus epidermidis (4%).
Antibiotics resistance phenomena was seen for many antibiotics, that may be cause of recurrent of Otitis media .

Abstract
Objectives: This study aims to document the experience of uterin rupture as a serious common complicaion of pregnancy in Basra (Iraq), it also aim to reviewing the main risk factors as to drow board lines for a strategy of prevention.
Methods :It is a retrospective study carried out at Basra maternity and child hospital (Iraq) medical records were reviewed for all patient with uterine rupture from the first of Jan. 1999 to the first of Jan. 2009 .
The data was analyzed and findings were reviewed to compare the result of similar studies.
Results:Out of a total number of deliveries in the studied peroid of (150514) 188 cases were diagnoised to have uterin rupture giving an incidence of 1:801. The main contributory factor of uterin rupture in this study were previous scar (29.7%) followed by CPD (26.5) follwed by PG insertion (12.7%). Around (67.02%) had complet rupture uterus. Subtotal hystrectomy was carried out in (55.2%), there was (9.5%) maternal mortality and perinatal mortality rate (62.7%).
Conclusion :This study confirm the existence of serious preventable obstetrical problem, poor provision of health services, low socio-economic standard and poor antenatal care so both social and medical improvement will significantly improve survival in the mother with rupture uterus and reduce perinatal mortality loss.

Abstract
Background:The present experimental study was conducted on tooth development during embryogenesis in developing mouse.
with main objective to identify the expression and action β -Catenin in
development of teeth and mophogenesis.
Materials and Methods:This study comprised a total of (21) sections were selected during different stages of tooth development (bud, cap and bell stage), (7) sections from each stage in developing mouse.
The expression of Beta-Catenin was carried out on 4µm specimen sections using Immuno histochemical staining of β-Catenin antibody.
The staining demonstrated the expression intensity.
Results:Results shows intense nuclear and cytoplasmic staining in inner enamel epithelium, outer enamel epithelium and in adjacent
dental papilla and ecto-mesenchymal cells surrounding the tooth germ, that will give rise to a definite dental sac,
while the stellate reticulum, shows only moderate cytoplasmic and not nuclear staining.
Conclusion: β-catenin is highly expressed during tooth development stages due to its role in cell signaling transmission between the enamel knot and the surrounding mesenchymal cells to induce tooth formation and its morphogenesis.

Abstract
Although the rapid advance in the understanding of molecular pathways underlying human tumorigenesis causes that initiate dysregulation of the pathways remain largely unknown. Human cytomegalovirus has been shown to transform cultured cells, however, viral DNA is not detected in most transforming cells, and the mechanism by which HCMV might contribute to oncogenesis has remained obscure.
For further investigation of HCMV role in human colorectal tumorigenesis, we have tested 13 specimens of colorectal adenocarcinoma & 5 specimens of villous adenoma using polymerase chain reaction (PCR) techniques.
The results of PCR assay showed specific single band in 9 of 13 specimens (69.23%) of colorectal adenocarcinoma, and 3 of 5 (60%) of villous adenoma, by using specific primer targeted directly to the early gene (pp65) that expressed within host DNA, the results read by agarose gel electrophoresis & UV –transilluminator.
The presence of HCMV genetic information in human tumors is a hot point because HCMV can infect the organs latently in a high percentage of normal individuals, it also remains possible that HCMV modulates the biologic properties of malignant cells without being directly involved in carcinogenesis.

Abstract
A Prospective clinical study , done in the orthopedic department of Aldiwanyia teaching hospital in the last year after introduction of arthroscopy in our hospital, including 30 patients with isolated traumatic meniscus injury , all of them are male, mean age was (27.5)year. All patients were under clinical assessment and MRI examination prior to the surgery to exclude other intra-articular lesion (cruciate ligaments injury or cartilage damage).
Surgery done for them, which including diagnostic arthroscopy to confirm the diagnosis and then, partial arthroscopic meniscectomy done( 19 patients, medial partial meniscectomy. 11 patients, lateral partial meniscectomy).
Each knee was classified 3 months after surgery as excellent, good, fair and poor result using criteria based on Hoover classification. There were 16 patients with excellent result (53.3%), 8 patients with good result(26.6%), 3 patients with fair result (10%),and 3 patients with poor result(1o%).
From overall results, we conclude that, that, our arthroscopic partial meniscectomy gives comparable results with the same surgery done outside our country, on short term follow up.

Abstract
Objective:- To evaluate the incidence and types of cutaneous manifestations in diabetic patients in Iraq.
Patients and methods:- One hundred diabetic patients attended the department of dermatology and venereology was evaluated. Sixty of them were male and 40 female. Sixty two percent of them had type I and 38% had type I diabetes mellitus I.
Result: - Neuropathic cutaneous lesions were found in 32.43% of patients. Dryness of the skin and hair loss being the commonest. Vascular skin lesions were 14.86 %, diabetic dermopathy and necropiosis lipodica constitutes the highest percent.
Cutaneous infections occurred in 20.7% weather bacterial or monilial infection. Drug eruptions were 10.36%, commonly complicate insulin therapy. Other miscellaneous skin lesions appeared in 21.62%. Purities were the commonest.
Conclusion: - Diabetic skin manifestations are not uncommon in both types of diabetes mellitus.

Abstract
This study aimed to assess the relation between cigarette smoking and changes in hospitalization for some common cardiovascular and respiratory diseases. Cigarette smoking has well-documented effects on most organs of the body. Previous studies have linked smoking consumption to a considerable disease burden and large healthcare expenditures. However, findings from studies based on individual level data were sparse and inconclusive.
Few studies have examined the relation between smoking and patterns of admission to hospital.
The annual rates of hospital admission attributable to three cardiovascular conditions ( myocardial infarction, angina, and ischemic stroke) and three respiratory conditions (asthma, chronic obstructive pulmonary disease, and chest infection) were studied during the period from August 2007 to July 2010, 1164 smoker patients were taken as active group and 856 nonsmoker patients were regarded as never smoker group (control group).
Smoking status was strongly associated with increased duration of hospitalization. For smoking-related admissions (active group),
odds ratios (OR) of 2.77 (95% CI 2.13–3.59) in men and 6.30 (95% CI 4.80–8.26) in women were observed among smokers compared to never-smokers. The study also showed a significant increase in the rate of recurrence of admission to the hospital (p<0.05) while nonsignificant changes in the control group. In addition the study revealed a significant association between smoking and increased rates of duration and recurrence of admission to hospital in women in comparison to men. The results of this study serve to expand the list of health outcomes that may be ameliorated by avoiding smoking .

Abstract
Twenty children with closed diaphyseal fracture femur were included in a prospective study at emergency department of Al-Samawa and Al-Rhumaitha hospitals from February 2009 to October 2010.There were 15 boys (75%) and 5 girls (25%) . Their age ranged from 10 months to 6 years. Left femur was fractured in 13 (65%) and the right one in the remaining 7 (35%).
Oblique fractures were the most frequently reported 12 (60%),followed by spiral fractures in 6 (30%), and transverse fractures in the remaining two (10%).
The mechanism of injury was fall at play in 10 patients (50%), road traffic accident (RTA) in 8 (40%) ,and bicycle accidents in the remaining 2 (10%) . Associated soft tissue injuries to other parts of the body had occurred in 4 (20%), all of these were of minor degrees and were treated conservatively.
The inclusion criteria used in this study were a patient with a 6 years or less of age with traumatic closed, uncomplicated diaphysal fracture of femur. All cases were treated by immediate hip spica casting under the sedative effect of intravenous diazepam in the emergency room (ER) and outpatient clinic depending on simple, available facilities without using general anesthesia nor C-arm. The duration of the spica was less than or 45 days in 14 patients, more than 45 days in 6 patients. Bony union was achieved in about 3 to 10 weeks (median 6) . There were no instances of malunion, nonunion, or rotational deformities.
At final follow-up, limb length discrepancy was noted in 5 children (25%) .Shortening of the fractured limb was 0.5cm in 2 patients, 1cm in 2, and 1.5cm in 1, but none had a discrepancy of greater than 1.5cm or a ‘short-legged’ gait. Mild degree of temporary knee joint stiffness was noted in all patients immediately following spica removal which had responded fully to a short course of home exercises programs.
The study concluded that immediate hip spica casting in the emergency room without prolonged traction in hospital and without the need of general anesthesia with its known adverse complications is a simple ,feasible and cheap method in treating uncomplicated femoral shaft fractures in children in the first six years of age.

Abstract
Swine Flu is a respiratory illness of pigs caused by type A H1N1 influenza viruses that cause regular outbreaks in pigs, while Swine Flu viruses normally do not infect human, the disease that has spread lastly to human, is a version of this virus, it was first identified in Mexico at April 2009,
It has since become a pandemic and spread quickly because few people have full resistance against it, so a cross-sectional study was conducted on 126 randomly selected paramedicals serving in ten different PHCCs in Baghdad, to find out their knowledge and awareness towards Swine Flu.
Data was collected by using previously structured questionnaires including 23 statements concerning the knowledge of disease, data was statistically analyzed by using simple binomial tests. The results show that the majority of correct premedical’s responses regarding disease definition(98.4%),spread of viruses between people through coughing or sneezing(97.6%),disease symptomatology similar to seasonal influenza (91.2%), immune suppressed people are more vulnerable to death(91.2%), different economic hazards(95.2%),prevention of disease through covering mouth and nose during coughing or sneezing(97.6%), only some disappointing responses regarding previous disease pandemics(35.%), circulation of the virus in humans, pigs and birds(42. 8%),no airborne infection between infected pigs (20.6%) and there are multiple vaccines given to pigs and not to human(19%).
Conclusion: An overall acceptable level of paramedicas knowledge and awareness regarding Swine Flu.
Recommendation was suggested for additional training and educational programmes as intensive courses for short periods with all available methods.

Abstract
This study was conducted to estimate the overexpression of HER-2
eu protein in human breast carcinoma in comparison to benign breast lesions and to show its possible correlation to the pathological parameters (histological type, grade and age). We evaluated the available tissue blocks of 50 patients with breast lesions (38 with invasive ductal carcinoma & 5 cases with fibroadenoma , 5 cases with fibrocystic disease & 2 cases with normal tissue) who had referred to Al-diwaniya Hospital between January 2007 and December 2010 All cases were female.
The mean age of the patients was 55 years (range, 33 to 77 years). The tumors were grade 1, 2, and 3 in 6 (15.7%), 19 (50%), and 13 (34.3%) cases, respectively. From 38 cases of IDC , A total of 12 (31.5%) patients were positive for overexpression of HER- 2/neu oncogene and From 12 cases of non malignant cases all of them were negative for overexpression of HER- 2/neu oncogene . The positive cases was with strong positive 3+ in 21.2% and in score 1 and 2 in 5.2% . High histologic grades of the breast IDC were associated with increased expression of HER-2/neu. There were 2 cases of HER-2/neu-positive (16.6%) with a grade 1 tumor, 4 (33.4%) with grade 2, and (50%) with grade 3 (P = .002 .There was a significant difference in HER-2/neu overexpression with the invasive ductal carcinoma and but no correlation was detected between HER-2/neu overexpression and the patient’s age.
Aim of the Study: This study was conducted to estimate the overexpression of HER-2
eu protein in human breast carcinoma in comparison to benign breast lesions and to show its possible correlation to the pathological parameters ( grade and age) .

Abstract
This study was conducted to isolate and identify the bacteria associated with tumor cells urinary bladder, in addition to investigate the histopathological changes in the urothelium of the urinary bladder.
A total of 130 urine samples were taken and classified into three groups:(36 samples belong to patients with urinary bladder cancer, 64 samples of urinary tract infections(UTIs),
and 30 samples as healthy group (control). These samples were collected from both sexes and different ages and lasted a period from January to June 2010 at Al-Diwaniyah Teaching Hospital.
The results revealed that 32/36 (88.8%) of urinary bladder cancer samples were positive for bacterial growth, while was 64/64 (100%) for UTIs samples.The common isolated bacteria associated with tumor cells of urinary bladder and UTIs were similar and included six species (Escherichia coli , Staphylococcus aureus, Proteus morganii, P.mirabilis, Pseudomonas aeruginosa, and Klebsiella pneumonia. But the percentage of isolation was varied and the high percentage belonged to Escherichia coli (34.5%), and the lowest was Klebsiella pneumonia (6.2%).

Abstract
The prevalence of vulvovaginal candidiasis caused by C. albicans and other Candida species has increased dramatically over the past few decades. Vaginal cultures and susceptibility testing of these Candida species to antifungal are not routinely obtained. Therefore the aims of this study were to
1. Determine the Candida species distribution among infected women with vulvovaginal candidiasis
2. Prevalence of antifungal resistance among isolated Candida species
One handerd vaginal swabs were collected from women their age ranged from 17-40 years old with signs and symptoms of vulvovaginitis attending Medical City Hospital. All swabs were submitted to mycological study (microscopical examination, culture, full identification by performing germ tube test and Api®-candida).
Finally, susceptibility testing was curried out by using modified disc diffusion method with six antifungal agents Amphotericin B, Nystatin, Fluconazole, Ketoconazole, Clotrimazole and Econazole. C. albicans was the most frequent species. (61.66%) followed by C.glabrata (33.33%) and only one isolate (1.6%) of C.tropicalis,C.krusie and C.kefyr, so the frequency of overall of other Candida species was (38.13%). However, few resistant C.albicans isolates were found against Fluconazole (21.62%), Ketoconazole (8.1%) and Econazole (5.4%).While no resistant was observed in C.albicans against Clotrimazole. Most of other Candida species were resistant to azoles specially among most isolates of C. glabrata to Ketoconazole 75%. Clotrimazole 70%, Fluconazole 65% and Econazole 20%.
Our results showed elevated frequency of the overall of other Candida species particularly C. glabrata which the most prevalent species followed by C.albicans. Other Candida species specially C.glabrata were resistant to azoles in contrast to the most of C.albicans therefore culture from women with vulvovaginal candidiasis should be obtained to detect other Candida species
Key words: Candida species, antifungal resistance, Iraqi women

Abstract
In this study compare between the effect of aqueous extract of green tea and Hibiscus sabdroffira on some immunological parameters in vivo . Five ml of watery extract of these was given in animal orally for three weeks after five weeks animals were killed and pieces of intestinal tract was collected to study local immunity .Green tea extract was shown higher significant at P ≥0.005 in stimulation systemic and mucosal antibodies than Hibiscus extract . Hibiscus sabdroffira was shown increase in total protein and secretory immunoglobulins .Two plants were show effect on cellular immunity by increasing LIF mucosally but not systemically.

Abstract
This study shows the effect of chloramphicol drug on liver and kidney tissues in male rabbits. We used eight animals for each group . The first group used as a control by using physiological saline( 0.9%) concentration . The second group were taken the drug( 250 mg) for sixteen days.
Biopsy were taken from the animals to examine their tissues histopathologically. Results were seen in liver tissues in the form of bleeding . cellular infiltration and necrosis .kidney tissues also reveal pathological changes like congestion and necrosis.

Abstract
In order to provide a standard reference of noise induced hearing loss for Kurdistan population in Erbil city from textile factory & dental laboratory, a hearing loss survey was conducted on 125 sample of different ages and both sex .The hearing threshold of air conduction and bone conduction was measured over a frequency range from 250 Hz to 8 KHz under standard condition.
Audiometric test was performed for the selected sample in a sound proof room, type (IAC). A pure tone manually operated Vienna tone type (Operating instruction MA 53), equipped with TDH 39 earphone mounted in Maico diagnostic GmbH. We faced in our ENT. practice patients complained of sensori -neural deafness especially in high frequency range they are working in different noisy places. In this study we selected our sample in the textile factory as its so noisy factory and so many adults persons working in it.

Abstract
A total of 125sera were collected from miscarriages women and healthy as control group. Latex agglutination test (LAT) and Enzyme linked Immunosorbent Assay (ELISA) were used to assess the presence of specific antibodies against T.gondii and CMV. 65(43&22) were positive for anti-Toxoplasma antibody. While 74 sera, (54 & 20) were positive for anti-CMV IgG and IgM antibodies respectively.
Whereas all control group 25 have been found to be negative for both T. gondii and CMV. The occurrence of two pathogens in relation to the residence, age and occupation has been studied. This study was conducted to detect the role of T. gondii and CMV in cases of miscarriage and detect the possible association between the two infections at the Children Maternity Hospital and private laboratories in Al-Diwaniyah Province during the period from November 2009 to march 2010.
The study has found that the highest prevalence of Toxoplasmosis recorded for women in the second trimester of pregnancy, whereas in the first trimester for CMV infection and in women with multiple abortions more than with single abortion for both pathogens.