Al-Qadisiyah Medical Journal

Background: A disintegrin and metalloprotein 33 (ADAM33) gene is the first asthma candidate gene identified by positional cloning, may be associated with lung function decline and bronchial hyperresponsiveness. However, replication results have been inconclusive in smaller previous study populations probably due to inconsistence in asthma phenotypes or yet unknown environmental influences. This study aimed to further elucidate the role of ADAM33 polymorphisms (SNPs) in a genetic analysis of our case- control. Materials and methods: One polymorphic sites (V4) of ADAM33 gene was genotyped in 69 patients with bronchial asthma, and 20 healthy controls. Genotypes were determined by the polymerase chain restriction fragment length polymorphism (PCR-RFLP) method. Data were analyzed using the chi-square test and SPSS version 20 computer software (Statistical Package for Social Sciences) in association with Microsoft Excel 2010. Results: The single nucleotide polymorphisms V4 G/C, of the ADAM33 gene may be participate in the susceptibility of bronchial asthma in the Iraqi population. Conclusion: Although ADAM33-V4 polymorphism not associated with asthma in many population, our study confirmed significant correlation between ADAM33-V4 and asthma.
Keywords: Asthma; Genetic; A disintegrin and metalloprotein 33; Polymorphism; Genotype; Allele.

Dermatophytes infection is a common problem worldwide and frequent in Iraq. Several reports and articles were published on prevalence, distribution, causes and treatment of dermatophytosis .
This case study was conducted on fifty patients(31males and 19 females) with suspected dermatophytes were studied . Their ages ranged from one year to fifty years .Patients admitted to Baghdad Teaching Hospital , Dept . of Dermatology , Baghdad during September 2010 to March 2011.Hairs and scales were collected and microscopicall examination using 20% KOH were done. Hair and scales from active outer border of the lesion were inoculated on modified Sabouraud's dextrose agar. Culture was incubated at room temperature(28C°) for 4 - 5 weeks. The identification of dermatophyte species was based on the gross , and microscopical and cultural characteristic according to standard mycological references .
The infection of dermatophyte was much higher in children below 10 years of age. Males 31(62%) were affected more than females 19(38%).Tinea capitis 19(47.5%) was the predominant clinical type .The main etiological agents was Trichophyton rubrum 20(50%) followed by Trichophyton mentagrophytes 13(32.5%).
The predominant anthropophilic dermatophytic species was Trichophyton rubrum.
This study was carried out to determine the prevalence, causative agents of dermatophytosis in group of Iraqi patients in Baghdad.

Background Internally displaced persons (IDPs) are those who have been forced from their home but, unlike refugees, remain within the borders of their own countries. Mental health is recognized as a key public health issue for conflict-affected populations. Studies revealed high levels of depression among IDPs
Aims of the study
This study aims to identify the prevalence rate of depression among IDPs who left their homes after the bombing of the Al-Askari Shrine in Samara and now are resettled in AL-Diwaniyah governorate.
Also to study the prevalence rate of depression in relation with some socio- demographic variables (such as age, sex, marital status, occupation, and education).Also measuring the severity of depression among those people.
Methods
One hundred ten IDPs have been randomly selected in one area of Al-Diwaniya governorate (Insaf village) from a period of august 2nd, 2012 to January 2nd,2013. The presence of depression was diagnosed by using a semi –structured interview schedule based on ICD-10, diagnostic criteria for depression ,and its severity was rated by Beck depression inventory. The patients group was matched for age and sex with control group to achieve comparability.
Results
The result showed that the prevalence rate of depression in IDPs was 34.5% compared with 16.4% among their matched control group and this result was statistically significant. The rate of depression was higher for females than males ,with some differences in depression rate among socio-demographic variable. And According to the Beck Depression Inventory (BDI) , the majority of our depressive patients(60%) were of moderate severity of depression
Conclusions
Depression is common in IDPs .

This prospective study was carried out on 720 patients with acute appendicitis admitted to the surgical unit at Al-Diwaniya Teaching Hospital over a period of 3 years from January 2010 to December 2012. The data of the patients regarding clinical history,physical examination, investigations,operative findings and histopathology reports were analyzed .Acute appendicitis was more common in the second decade of life (44.4%) and was more common in males(55.97%) than in females (44.02%) .Perforated appendicitis was found in 144 pateints (20%).The incidence of perforated appendicitis was high in males (56.25%) as compared to females (43.75%). The risk factors for perforation in acute appendicitis include:extremes of age (< 10 years and > 60 years) ,delayed presentation (> 72 hours), diabetes mellitus ,steroid dependency , elevated temperature (>38˚C) ,raised WBC count (>18.000 mm3), pelvic appendix ,obstructive appendicitis (fecolith) , and pregnancy (the P-value was <0.05). The morbidity and mean hospital stay were more in perforated appendicitis than in non perforated appendicitis .The mortality rate in perforated appendicitis was (2.08%) , while there was no death recorded in non-perforated appendicitis. We should be aggressive in the treatment of appendicitis in high risk patients, so once acute appendicitis is diagnosed , the expedient surgery and appropriate use of perioperative antibiotics can help to minimize the morbidity and mortality.

Background: Children with chronic illnesses need continuous correlation with pediatrician. Assessment of patient satisfaction allows health care providers to explore the extent to which their service meets the needs of their patients. Interview techniques are important for explanation of the problem to the family. The pediatrician deals with respect to the parent's ideas to improve their self-esteem and competency
Objective: To assess maternal satisfaction of pediatric providers of children with selected chronic illness.
Patients and Method: A cross sectional study, conducted in Babylon Gynecology and Pediatrics Teaching Hospital (wards and outpatient clinic), Al-Hilla, Iraq. From October 2011 to November 2012. Information was collected by interview with mothers of 110 children with one of four chronic illnesses (asthma, diabetes mellitus, cerebral palsy and congenital heart disease) to determine their response about pediatric providers whom they consulted in the last year, seen most frequently, and who were seen over the longest period of time. Rates of dissatisfaction with those providers are also reported.
Result: The probability of reporting a high level of satisfaction (extreme satisfaction) was for subspecialist pediatric care providers than with specialist pediatrician, P- value <0.04, but mothers mentioned that specialist pediatrician providing better general health care, P-value <0.001,realy listening to their opinions, P-value <0.002,and ability to answer questions about condition, P-value <0.02.
Conclusions: Achievement of Mothers-pediatrician communication ensures best maternal satisfaction

Background:-Polycystic ovary syndrome (PCOS) is common in women of reproductive age and it’s commonly associated with endocrinal and biochemical derangements. Moreover PCOS also associated with increase cardiovascular risks such as adverse lipid profile and endothelial dysfunction. Recently, statins have been shown to improve endocrine and metabolic aspects of PCOS.
Aim of the study:-The aim of this study was to evaluate effects of rosuvastatin as adjuvant therapy in treatment of polycystic ovarian syndrome.
Materials and methods:-The study was conducted at Al-Kadhemia Teaching Hospital, Department of Obstetrics and Gynecology from February 2014 to December 2015. In this study 96 women with PCOS randomly divided equally to two study groups; Group (A) in which patients were allocated to receive metformin (500 mg three times a day) plus rosuvastatin (10 mg/day) and group (B) in which patients were allocated to receive metformin (500 mg three times a day)plus placebo for 12 weeks. Blood samples were obtained before and after treatment for determination of fasting blood sugar, follicle stimulating hormone, luteinizing hormone, Dehydroepiandrosterone sulfate, serum testosterone and total lipid profile.
Results:-At the end of study period, 89 patients complete the study (45 patients in Group A vs 44 patients in Group B). There were a significant decreases observed in both groups with respect to body mass index, fasting blood glucose, testosterones and luteinizing hormone whereas dehydroepiandrosterone sulfate, total cholesterol, low-density lipoprotein cholesterol and triglyceride declined significantly only in Group A.
Conclusions:-Rosuvastatin as adjuvant therapy in patients with polycystic ovarian syndrome has many beneficial effects.

Sixty two thalassemic patients who were regularly attending maternity and obstetrics teaching hospital Al- Diwaniya ,(22) who were apparently healthy, all have enrolled for serological screening during the period ( January 2013- March 2013)
The ELISA is used to evaluat the load of HBs-Ag, HBC and HBs-Ab.Only one case has given positive for HbsAg test , while (2) of the patients showed positive test for HCV .Moreover,4(6.5%) patients had no HBs-Ab in their serum and at high risk of contract infection . The titer of these antibodies has shown to be negatively correlated with number of blood transfusions .A regular screening for Hepatitis immunologic status is recommended.
Aims of the study to detect and clarify the immunologic status of β-thalassemia patient by evaluation of hepatitis B and C , antigens and antibody using ELISA.

Objective:To evaluate the sensitivity and specificity, negative predictive value (NPV), and positive predictive value (PPV)of ultrasonography (US) in distinguish benign solid breast mass from malignant one.
Patients and methods: Between April 2009 and October 2012 , 243 female patients with breast lesions diagnosed by their managing surgeons, were sonographically assessed .Those who had solid lesions were selected for a prospective study through comparison with the histopathological finding of the open biopsies taken from the lesions . US features that most reliably characterize masses as benign or malignant had been strictly applied for diagnosing these cases. Sonographic classifications were compared with histopathological reports of the biopsies . The sensitivity, specificity, and negative and positive predictive values of the sonography were calculated.
Results:Sonographically ,108(44%) cases were classified as benign and 135(56%) were malignant . 12 (11%) lesions classified as benign sonographically, were found to be malignant histopathologically. 33 (24%) lesion classified as malignant were found to be benign histopathologically . Thus, the classification scheme had a negative predictive value of 89% and positive predictive value 75%.
Conclusion: Sonography could help in distinguish benign solid mass and can be follow up .

Objective: As far the prostate size is an important parameter to determine the way to treat the patient with BPH and the type of surgery used, so the objective of our study was to compare and evaluate the ultrasonographic size of the prostate by suprapubic rout with the real postoperative prostate size.
Materials and Methods: between July 2011 and May 2012 forty three patients underwent both preoperative suprapubic ultrasonography (SPUS) and either transvesical or retropubic prostatectomy for BPH was included in this study. Using ellipse volume calculation (height, length and width), SPUS prostate volume was determined, and was compared with the measured volume of the specimen post-operative.
Results: Prostate volume measured by SPUS, correlated closely with real specimen volume. The study revealed no significant difference between SPUS prostate volume and real post-operative specimen volume.
Conclusion: Prostate volume measured by SPUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, it’s more comfortable to the patients and noninvasive procedure.

Background:Systemic narcotics commonly used for postoperative analgesia are associated with many side effects.
Many studies regarding the best postoperative analgesic regimen with minimum side effects have been done over the last 20 years.In this study we compare between the postoperative intravenous infusion of tramadol with the postoperative intravenous infusion of ketamine.
Method : This stidy was carried out on 120 parturients prepared for an elective caeserian section under general anaesthesia . All patients subjects according to American Society Of Anaesthesiologist ( ASA) classification were grade 1 & 2 between 20 – 40 of age. Subject were allocated into two groups ( 60 patients in each group ) :
Group A ( Ketamine group ) ( n = 60 ) patients received a bolus dose of ketamine( 0.3 mg/kg) followed by an intravenous infusion at 0.1 mg • kg−1 • h−1) postoperatively.
Group B (Control group) ( n = 60 ) patients received a bolus dose of tramadol ( 2 mg/kg ) followed by an intravenous infusion (0.2 mg • kg−1 • h−1) postoperatively
Diclofenac suppositories were given to both groups postoperatively.
Results: The ketamine group had less pain at rest and with movement , required less diclofenac suppositories throughout the 24 h study period. Ketamine, improved subjective analgesic efficacy . Hallucinations were more common in ketamine patients, but other side effects were similar.
Conclusion: Small doses of postoperative intravenous infusion of ketamine is a better choice for postoperative analgesia than an intravenous infusion of tramadol.

This study is aiming at exploring breast cancer related knowledge, attitude and practices toward breast cancer and breast self-examination (BSE) and to evaluate the effects of educational level on them. For this a cross sectional study covering 234 women attending Primary Health Care center in Kufa city, Najaf governorate was carried out during the period of 1st of November 2012 to the 1st of February 2013, data collection was done by using questionnaire forms containing demographic and, questions related to the symptoms and signs of breast cancer, questions about the risk factors, questions related to BSE practice.
Results showed that 48.7% of the participant had a low level of education,38.8%, 12.4% had moderate and high levels respectively with no significant statistical association (p=0.322). Although 74.4% of the participants had been heard about BSE only 21.8% of them practiced it regularly. The main causes for non-practicing BSE were afraid to find out a lump and lack of information about it. Only 24.4% knew the correct time of BSE for postmenopausal women while 42.3% knew the correct time for premenopausal women. The main source of information was from television. Results also showed that 74.4% of the participants knew that breast cancer can be prevented through early diagnosis by BSE and mammogram.
These results indicate that women have poor knowledge of breast cancer and minority practice BSE .although, education must be the major determinant of level of knowledge and health behavior among the community but in this study e was no relation between educational level and the overall knowledge level.

Pseudomonas aeruginosa became an important cause of wound and burn infections and serious mortality in burn patients. The virulence factors of these bacteria including their capacity to form biofilm, their ability to hold antibiotics resistance genes as well as rapid motility in vivo and in vitro. Thus the present study was designed to highlight some the virulence factors among different strains of Pseudomonas aeruginosa. All isolated strains (10 isolates) had the capacity to produce biofilm ,one of them (No.3) has shown high level of biofilm (OD.2.5) and it was resisted to most antimicrobial agents; for this reason further investigation was carried out including gene expression by PCR technique and motility. Results showed that all strains were able to resist most common antibiotics; the molecular study for Strain 3 gave clear band of gene size 1.2pb which is responsible for resistance to aminoglycoside group. Understanding the virulence factors mechanisms of Pseudomonas aeruginosa is of a big importance in order to reduce the mortality in burn patients.

Identification of the parathyroid gland during surgery of thyroid reduce the risk of postoperative hypoparathyroidism; as well as of great importance for identification of the parathyroid glands in parathyroid disease.
It is a prospective study conducted on (50 patient 10 male and 40 female) with various causes of goiter, who underwent operation in the the Surgical Department of the AL-DIWANYIA TEACHING HOSPITAL for the period between May 2008 to September 2010.
The technique of methylene blue dye injection through the inferior thyroid artery using one CC methylene blue 0.5% to recognize the parathyroid gland in patient suffering from various causes of thyroid disease and undergoing thyroid gland surgery. The precise localization of the gland was possible in 85% . There were no adverse effect from this technique.
We conclude that peroperative identification of parathyroid gland using methylene blue is valuable technique that facilitates identification of the gland at operation.

This study is designed to determine the degree , type of deafness, and site of lesion in the auditory pathway of deaf children by using Brainstem evoked response audiometry.
This study is prospective in nature. It considerd 56 patients with deafness which were assessed between July and December 2010 in E.N.T outpatient clinic, department of otolaryngology, in Al-Diwaniya teaching hospital, AL-diwaniya city, Iraq.
The study shows that The degrees of deafness are: out of 56 patients, 12 patients (N=12, 21.4%) have mild deafness (20db- 40db loss), 16 patients (N-16, 28.6%) have moderate defness (40db- 60db loss), 28 patients (N=28, 50%) have sever or profound deafness (60db- 100db loss). The type and site of deafness are: out of 56 patients, 11 patients (N=11, 20% have conductive deafness, 26 patients (N=26, 46.4%) have cochlear (sensory) deafness, 17 patients (N=17, 30%) have retrocochlear (neural) deafness, 2 patients (N=2, 3.6%) have cortical deafness.
the brainstem evoked response audiometry valuable audiological test to assess the auditory pathway in children.

Background: In glaucoma, as optic neuropathy gradually proceeds unnoticed by the patient, early detection and treatment is of paramount importance in arresting or controlling the progress of damage.
Aim of the study: To explore effects of topical carvedilol on intraocular pressure (IOP) in each of normotensive and ocular hypertensive eyes of rabbits, with assessment of drug safety.
Material and methods: A group of 54 males rabbits were included in this study. Induction of ocular hypertension was achieved by injection of hydroxy propyl methylcellulose in the anterior chamber of rabbits right eye. The present study was designed to evaluate the possible beneficial therapeutic effect (part I) and both prophylactic as well as therapeutic effect (part II). The included rabbits were divided into distilled water group, timolol (0.25% and 0.5%) groups, and carvedilol (0.25% and 0.5%). Each of drug eye drops (including distilled water) were instilled into right eyes 3 times/day for 4 days prophylactically and for 10 days therapeutically. The rabbits had been examined for the IOP, pupil diameter, light reflex, corneal reflex, and conjunctival redness prior to instillation of drugs and along the trial period.
Results: Ocular hypotensive effects of carvedilol (0.25%) and (0.5%) eye drops were more efficient than that of distilled water (P<0.01). Furthermore, carvedilol (0.25%) eye drop simulated timolol (0.25%) eye drop (P>0.05) in its ocular hypotensive effect along the trial period.
Carvedilol eye drop required 4 days of instillation into normotensive eyes to achieve highly significant (P<0.01) ocular hypotensive effect whereas 10 days were needed to do so in ocular hypertensive eyes; such ocular hypotensive effect was more efficient than that of distilled water, but less efficient than that of timolol eye drop.
In both parts of the present study and regarding each of mean pupil diameter, light reflex, corneal reflex and conjunctival redness, carvedilol (0.25% or 0.5%) eye drops had no significant adverse effect (P > 0.05).
Conclusions: Carvedilol eye drops instilled 3 times / day had an obvious prophylactic role in normotensive and a beneficial, safe, and tolerable therapeutic ocular hypotensive effects on hydroxy propyl methyl cellulose - induced ocular hypertension in rabbits.

Objective: This study has been carried out to asses the activity of magnesium in the serum of patients with diabetes mellitus. Also the effect of glycemic control on magnesium levels was investigated.
Subjects and Methods: Ninety six patients with diabetes were enrolled in this study, together with 95 healthy subjects, matched for age and sex, who served as the control group. The serum levels of glucose, creatinine and magnesium were estimated in all subjects. Glycated hemoglobin (HbA1c) was estimated in diabetic patients and according to its level we classified the diabetic into 2 groups: Group 1: good glycemic control (57 patients). Group 2: poor glycemic control (39 patients).
Results: Serum magnesium levels in diabetic group were found to be significantly lowered than in control group. We found a direct correlation between the Glycosylated hemoglobin and magnesium levels in our study.
Conclusion: The present study revealed that there is inverse relationship between the magnesium levels and the glucose homeostasis in diabetic patients. Furthermore, there is an affirmative effect for the glycemic control on the level of magnesium in diabetic patients.

Background: Electrical injuries, though uncommon and largely preventable ,they usually have serious consequences including death.
Objectives: To study the pattern of electric injuries, and recognize the factors that increase their mortality so that we can reduce it .
Materials & Methods :A retrospective study of sever electrically injured cases in Babil Governorate during a period of 15 months, from January 2006 to March 2007 (included) was carried out. From the records of the burn wards of Hilla Teaching General Hospital and the autopsy records of Forensic Pathology Department of Babil Health Directorate, sever electrically injured victims were retrospectively studied according to the type of electric injury, the voltage, associated secondary traumatic injury and whether it is work related or not. .The age ,sex , location of entry and/or exit of the electric current and the emergency resuscitative measures applied in the Emergency Departments (EDs)were considered .
Results:. The total number of electrically injured victims ( both hospitalized and non hospitalized ) were 33, 30(90.9%) cases due to contact with low voltage, 2(6.7%) due to high voltage and 1 (3.3%) due to lightning strike. Out of 28 cases for whom cardiopulmonary resuscitation was indicated, only in 14(50%) cases ,its application was recorded in the cards of Emergency Departments.
Conclusions: The mortality rate following electrocution ,in Babil, was 93.93% which is too high in comparison with the international studies rate of 3-15%

Background: Acute idiopathic thrombocytopenic purpura(I.T.P) is a bleeding disorder in which the immune system for unknown reason produce antibodies against platelets, which are necessary for normal blood clotting resulting in decrease number of circulating platelets, manifested itself by bleeding tendency, easy brusing or extravasation of blood from capillaries in the skin and mucous membrane .
Objective: to choose the most appropriate therapy for acute idiopathic thrombocytopenic purpura management .
Methods : 65 patients were enrolled in this retrospective study, who were admitted to AL-Zahraa teaching hospital from January 2000 to January 2010 . Relevant information were collected according to preceding data collection sheet that include age, sex, initial hemoglobin and platelets count, treatment given, response to therapy…These patients subdivided into 3 groups according to initial drug used for their management either prednisolone, I.V.immunoglobulin-G, or anti-D. The response was analyzed according to rapid rise of platelets number in the pre-treatment state. chronic cases of I.T.P were excluded from this study .
Results: All patients were aged from 2-12 years with peaks of 2-5 years. Sex ratio (femalemale) of 1:1.7 .Our study showed that out of 65 patients, 37(57%) of them were assigned as group 1 who received prednisolone as a conventional therapy ,the response was noted in 31( 86.5%) after few days of treatment. Regarding group 2 patients received I.V immunoglobulin-G, the response of platelets rise was noted in 16( 89%) of cases out of 18 patients . While(10) patients in group 3 who received anti-D as main line of treatment to Rh-positive individuals, the response is observed in only 6( 60%) of cases .
Conclusion: Regarding various treatment modalities of idiopathic thrombocytopenic purpura ,it has been noted that oral prednisolone is the best, single, readily available, inexpensive drug that can be taken orally and as outpatient .
Recommendation:The availability of other treatment options such as I.V-immunoglobulin-G should be adopted in our hospitals in cases of life- threatening illness as it induces more rapid rise in platelets in comparison with other drugs.

The aim of the present study was to investigate the effect of daily oral administration of local Ethanolic Extract of Propolis (EPP) on blood glucose, antioxidant defense system and kidney function in streptozotocin (STZ)-induced diabetic rats to show the ameliorating and partly curative effects in STZ-induced rats(60mg/kg) intrapretonial (i.p). Seventy five rats (150-160gm) were divided into 5 groups, normal rats, diabetic rats, normal treated with local EEP for 6 weeks, pretreated with local EEP for 3 weeks then induced diabetic in rats for 3 weeks and the last group, after 3 weeks(normal) induced diabetic in rats then post- treated with local EEP for 3 weeks. The dose of EEP 200mg/kg for the last three groups, and groups 2, 4 and 5 were induced diabetes in the same time at the end of the first 3 weeks.
After 6 weeks , serum of samples were collected from anesthetic rats to determined the biochemical alterations.
Antioxidant status in rats were estimated by determined the Glutathione(GSH) concentration, and Glutathion peroxidase (GPx) activity, and also measured renal function by the tests of Serum Urea and Creatinine concentrations, the result of this research indicated the effect of local EEP as protective or therapeutic in this experiment, the diabetic group showed decreased significantly(p<0.05) in body weight gain, increased(p<0.05) blood glucose, decreased significantly(p<0.05) activity of GPx and GSH concentration and increased significantly(p<0.05) serum Urea and Creatinine concentrations, as well as local EEP was moderated and effected significantly decrease(p<0.05) glucose level, Urea and Creatinine concentrations, increased significantly(p<0.05) activity of GPx and GSH concentration, as a result, it led to protect the kidney from damage by moderated their functions.

Back ground: A retrospective preliminary study was undertaken to estimate the most common causes of Burn in infantile and pre-school children.
Patients and method: children aged between 1 to 5 years were included in this study who had admitted in burn specialized center in Baghdad from September 2010 to June 2011, reviewed by their age, sex, time of presentation, causes and mechanism of burn injury .
Result: scald burn is the most common cause of burn in children bellow five years of age (19 cases), male patient more predominance in this age group (66.7%), the age distribution , 1,2,3,4,5 years was 1,7,12,5,2 cases respectively .

Background:
Increasing interest in quality of life is the new approach for understanding and improvement of healthcare. Although there are many studies about quality of life in schizophrenic disorder, there is deficiency of data about quality of life of schizophrenic patients in urban and rural areas.
Objectives:
1-To study the quality of life of schizophrenic patients who are living in both rural and urban areas.
2-To identify any possible factors that might need further attention for treatment planning programs.
Methods:
This study was prospectively conducted between October 2010 and May 2011, on 126 schizophrenic patients attending the outpatient clinic in Al-Rashaad training Hospital.we explain the purpose of the study to patients and take their consent; patients should have stable clinical condition (on regular treatment for at least 6 months, continuous course, not agitated or confused). International Diagnostic check list of (ICD 10)(9) andWorld Health Organization(WHO)Quality of life (QoL)-100 Arabic version(10) were used.
Results:
Patients from rural areas scored significantly higher than urban patients in all six domains (Physical health, Psychological health, Level of independence, Social relationships Environmental, and Spiritual domain) . Studying different demographic variables in correlation with quality of life ,showed the same manner .
Conclusion:
This study showed that schizophrenic patients living in rural areas, had relatively better quality of life than those living in urban areas.

Hypercalcemia is the most common life threatening metabolic disorder associated with neoplastic diseases, occurring in an estimated 10-20% of all persons with cancer.
Solid tumors (such as lung or breast cancer) as well as hematological malignancies (particularly multiple myeloma) are frequently associated with hypercalcemia.
Our study aims to detect the incidence of hypercalcemia in variable malignancies,130 patients, 67 female and 63 male who are presented to surgical and medical wards as a proved cases of malignancies by histopathological and/ or cytological examination were included in a prospective study in which serum was obtained with out use of tourniquet in supine position to measure total serum calcium, from all patients collected there were only 7 having hypercalcemia, 3 out of them were having breast cancer, 1 lung cancer, 1lymphoma, 1leukaemia and 1GIT cancer, thus from this study we concluded that the breast cancer is the most common tumor associated with hypercalcemia and this can accuse hypercalcemia in female more than male.

This study was conducted to detect the association of Helicobacter pylori on diabetic patients. A total of ( 170) sera were collected and H. pylori Immunochematography assay (Sandwich ELISA Method) were used to assess the presence of specific antibodies against the occurrence pathogen in relation to residence ,age and occupation has been studied. In this study 170 patients with fasting and / or random plasma glucose, from one handered patients 70 (44) males and (26) females , aged of (20-60) years were positive for H. pylori enrolled, and seventy non – diabetic (38)males and (32)matched for age, sex and family history of non- diabetes mellitus ,not pregnant who who were attending the medical clinic (outpatient).

The present study aimed to isolate Enterobacteraerogenes from urine of patient with UTI and showing its pathogenicity in mice, a total 150 urine specimens were collected and cultured on MacConky agare then tested biochemically and with API- 20 to confirm diagnosis of Enterobacter aerogenes, after that injected 4 groups of mice with (108,109 and 1010 CFU/ml) respectively, while fourth group consider as a control group, also extracted the cell wall from Enterobacteraerogenes and used four groups of mice to injected with different concentration(300, 200 and 150 µ/ml) of extracted cell wallrespectively, while fourth group consider as a control group. Results shows that 11 isolates of Enterobacter were obtained from urine and out of 11 isolates 8 isolates were belong to Enterobacter aerogenes. Bacterial isolation from internal organs showed very heavy isolation of Bactria in dose 1010 CFU/ml as compared with other dose, histopathological changes of organs for mice injected with live bacteria and extracted cell wall revealed same the tissue damage as compared with control groups.

The present study aimed to isolate Enterobacteraerogenes from urine of patient with UTI and showing its pathogenicity in mice, a total 150 urine specimens were collected and cultured on MacConky agare then tested biochemically and with API- 20 to confirm diagnosis of Enterobacter aerogenes, after that injected 4 groups of mice with (108,109 and 1010 CFU/ml) respectively, while fourth group consider as a control group, also extracted the cell wall from Enterobacteraerogenes and used four groups of mice to injected with different concentration(300, 200 and 150 µ/ml) of extracted cell wallrespectively, while fourth group consider as a control group. Results shows that 11 isolates of Enterobacter were obtained from urine and out of 11 isolates 8 isolates were belong to Enterobacter aerogenes. Bacterial isolation from internal organs showed very heavy isolation of Bactria in dose 1010 CFU/ml as compared with other dose, histopathological changes of organs for mice injected with live bacteria and extracted cell wall revealed same the tissue damage as compared with control groups.

In this study was undertaken to detect some virulence factors to co-infection of intestinal fungi (Candida albicans, Aspergillus fumigates) and parasite (Giardia lambelia, Entameba histolytica) in immunocompromised patients by polymerase chain reaction(PCR)technique.
About, 100 specimens of stool were collected from three groups of patients included malignant tumor (35), , renal failure (50) and HIV (15) during period 5 November 2012 to 15 May2013.
The results of this study showed the highest rate infection(66.66%) was in HIV while lowest rate (57.14%) were in malignant tumor patients .So the highest rate were recorded in age group (60-75),then male recorded rate infection(69.04%) while in female (53.44) but statically no significant difference between two groups.Candida albicans recorded highest rate prevalence recorded to (41%) followed by Aspergillus fumigates (34%) and Giardia lambelia (53%) while Entameba histolytica (46%).
According to the results of molecular test showed Candida albicans contain asp gene in (350 bp) sequence and Aspergillus fumigatus contain Gliotoxin gene in (550bp) sequence. So Giardia lambelia contain Cystine Rich Protein CRP65gene in (460 bp) sequence and Entameba histolytica contain Lectin(hg13) gene ( 900 bp) The results of this study showed the yeast and fungi appeared high resistant to antifungal which used in this study except Amphotericn B which were sensitive to it by rate (80%).

Bentonite clay is widely used in pharmaceutical industry and medical applications. A batch adsorption system has been applied to study the differences between the adsorption of Fe in ferrosam (FeSO4.7H2O) and Fe in hemavit (C4H2FeO4) on the Iraqi bentonite. The adsorption percentage (Q%) of Fe in ferrosam reached to (96.2 - 96.6)% while the percentage for hemavit reached to (71.3- 80.7)% at the temperature range (303-323) K.
The adsorption isotherms for ferrosam was a Langmuir type while the adsorption isotherm for hemavit was Freundlich type. Thermodynamics and kinetics parameters of the adsorption of two drugs has been calculated in details. The results were shown that higher adsorption of Fe in ferrosam as (inorganic formula) than the adsorption of Fe in hemavit as (organic formula).

Introduction: Tinnitus is a sound perceived for more than five minutes at a time, in the absence of any external acoustical or electrical stimulation of the ear and not occurring immediately after exposure to loud noise. It is either subjective, audible only to the patient, or objective, audible to the examiner as well. It is a complex symptom, as it is usually associated with other neurotological complaints.
Aim of study : To evaluate the distribution and the possible causes of tinnitus in Al-Diwania city.
Method: This is a randomized analytic descriptive study, consisted of 200 patients. They were 110 males and 90 females . They had been assessed at the otolaryngology department in Al-Diwania teaching hospital, in Al-Diwania city in Iraq, during the period between April 2013 to September 2014, the age ranged from 10-80 years .We asked every patient about any sound in the ear or head lasting 5 minuts or longer, and whether it was unilateral or bilateral, followed by The clinical examination which included neurological, otorhinolaryngological assessment and audiological evaluation. In the patients with suspected neurological problem we did magnetic resonance imaging. For assessment of hearing loss we did pure tone audiometry and tympanometry.

Results:most of our the patients ( 86 %) were above 40 years old, the most common causes were otological diseases (98%),while the non otological diseases found in ( 2%) in form of temporo-mandibular joint disorders . The most common otological causes were noise-induced hearing loss (include acoustic trauma) (30%) followed by presbyacusis (21%)and wax impaction (15%). The other otological causes were: otitis media with effusion(13.5%), followed by chronic otitis media(7.5%), sudden hearing loss(5%), acute otitis media (3.5%), meniere's disease (1.5%),and ototoxicity (1%).
Conclusion: The incidence of tinnitus increased with age,and the majority of the patients were above 40 years old. The most common causes were otological diseases. The most common otological causes were noise-induced hearing loss followed by presbyacusis and wax impaction.

Fifty patients with chronic renal insufficiency underwent clinical evaluation & studies of thyroid function the results were compared with age & sex-matched controls. (20%) of patients had biochemical hypothyroidism with low serum T3, T4, & high serum TSH. All the members of the control group were biochemically euthyroid. The mean values of serum T3, T4 were significantly lower & mean serum TSH was significantly higher as compared to controls. There was no correlation of thyroid functions with decrease in renal function. To conclude thyroid dysfunction occurs both clinically & biochemically in patients with chronic renal insufficiency.

Background:-Toxoplasmosis is an infectious disease caused by Background:-Toxoplasmosis is an infectious disease caused by unicellular opportunistic parasite called Toxoplasma gondii. The disease can be very serious and even fatal in fetuses, newborns, and individuals with weakened immune systems, in addition to the risk of gestation complications and congenital problems.
Aims of the study:- The purpose of the present study to determine the relationship between Toxoplasmosis in the children who afflicted with congenital deformities.
Materials and Methods:- The eighty eight samples were collected (blood) from the children who afflicted with congenital deformities in Al Alwaiya Children's Hospital and used ELISA technique to determine IgM and IgG Toxoplasmosis, in addition to eighty eight apparently healthy children as a control group.
Results:- The results showed that among eighty eight children afflicted with congenital deformities there are 21 (23.86%) positive for IgM and 33 (37.50%) positive for IgG, while the results of IgM and IgG in the control group were 3 (3.14%) and 7 (7.95%) respectively with highly significant variation p=0.001.
Conclusion:- The present study showed there is a relationship between the infection by this parasite and congenital deformities. But it cannot be certain Toxoplasmosis is the real cause of congenital deformities in those children, and in the same time it doesn't deny the impact.
unicellular opportunistic parasite called Toxoplasma gondii. The disease can be very serious and even fatal in fetuses, newborns, and individuals with weakened immune systems, in addition to the risk of gestation complications and congenital problems.
Aims of the study:- The purpose of the present study to determine the relationship between Toxoplasmosis in the children who afflicted with congenital deformities.
Materials and Methods:- The eighty eight samples were collected (blood) from the children who afflicted with congenital deformities in Al Alwaiya Children's Hospital and used ELISA technique to determine IgM and IgG Toxoplasmosis, in addition to eighty eight apparently healthy children as a control group.
Results:- The results showed that among eighty eight children afflicted with congenital deformities there are 21 (23.86%) positive for IgM and 33 (37.50%) positive for IgG, while the results of IgM and IgG in the control group were 3 (3.14%) and 7 (7.95%) respectively with highly significant variation p=0.001.
Conclusion:- The present study showed there is a relationship between the infection by this parasite and congenital deformities. But it cannot be certain Toxoplasmosis is the real cause of congenital deformities in those children, and in the same time it doesn't deny the impact.

Background LVSD or HF associated with end organs problems such as arrhythmias' or thromboembolization. Previous studies showed that reduction in LV pump function(i.e. EF) is associated with increased incidence of stroke and high prevalence of LVSD among patients with stroke. Screening for LVSD is important in patients who had high cardiovascular risk factors such as hypertension, diabetes ,smoking and dyslipidemia .It had been suggested that should have screening for LVSD
Aim of the study is to look for the frequency of LVSD among patients suffering recent ischemic stroke who were who admitted to the neurological wards
Patients and Methods 52 patients with diagnosis of stroke and who were admitted in Middle Euphrates Neurological center were evaluated for their left ventricle (LV) systolic dysfunction .The mean age( 60.08 ), ( 17 females and 35 males) The major risk factors of stroke as the hypertension,, diabetes the dyslipidemia. and smoking were recorded. The stroke was classified either hemorrhagic or ischemic by CT brain .Echocardiography with Doppler study and EF was recorded
Results The study confirmed the high incidence of LVSD among patients with stroke .There was a significant relation with stroke in cases with mild and moderate reduction in the EF.
Conclusion reduction in systolic left ventricle of the heart can be considered as possible risk factor for stroke.
Key Word :- Stroke ,Ejection Failure

Background: Being able to predict preterm birth is important, as it may allow a high-risk population to be selected for future interventional studies. As inflammation represents a crucial pathogenic process of preterm delivery, the aim of this study is to define the role of serum inflammatory markers in the prediction of spontaneous preterm delivery & to combine these markers with cervical length to increase the diagnostic accuracy.
Methods: Eighty pregnant women with threatened preterm labour (group I) were compared with 40 women at term (group II (, subdivided into 2 subgroups (20 of them were not in labour & the other 20 were in labour). Neutrophils to lymphocytes ratio (NLR) & C-reactive protein (CRP) level were measured & compared for all study subjects. For group I, transvaginal cervical length was measured & combined marker (defined as NLR divided by the cervical length) was estimated & they were subdivided into: (group Ia) who delivered before 37 weeks (n=30) & (group Ib) who delivered at term (n=50).
Results: The levels of NLR (P<0.001), CRP (P<0.016) in group Ia were significantly different from those in group Ib & they were also significantly higher in group IIa than in group IIb (P<0.001). The cervix length (P< 0.001) & combined marker (P<0.001) in group Ia were significantly different from those of group Ib. It has been shown that the combined marker has higher sensitivity (65%) & specificity (87%) for prediction of preterm delivery, as compared to cervical length or systemic inflammatory markers each alone.
Conclusions Combined marker is useful for identifying women at risk of preterm delivery in patients with threatened preterm labour.