Al-Qadisiyah Medical Journal

Abstract
Background: Migraine is a well known neurologic disease, ordinarily portrayed by intermittent assaults of incapacitating headache and manifestations of autonomic nervous system disturbances. In about 33% patients, headache attacks are joined by transient “focal neurologic aura manifestations”. Migraine is a neurovascular disease accompanied by cranial vascular contractile dysfunction, neurogenic inflammation and cortical spreading depression. Brain tissue activation results in the production of peptides by the perivascular trigeminal areas which lead to an inflammatory response with dilation of extraparenchymal blood vessels. Inflammatory vasculopathy accompany repeated assaults of migraine attacks. A number of studies showed the elevation of certain inflammatory markers in association with migraine such as adhesion molecules, interleukins and C-reactive protein (CRP).
Aim of the study: To evaluate the role of HS-CRP in patients with migraine
Patients and methods:Current cased control study included 100 patients with migraine headache and 100 apparently healthy subjects. Variables included in the present study are: age, gender and the level of highly specific C-reactive protein (HS-CRP). The study was conducted at the neurology unit, Al-Dewaniyah teaching hospital, Al-dewaniyah province, Iraq. The study started on January 2018 and ended at June 2018.
Results: Current study included 100 migraine patients with a mean age of 31.46 ±5.75 years and 100 control subjects with a mean age of 30.55 ±5.54 years and there was no significant difference in mean age between the two groups (P=0.255). Patients group included 23 men (23%) and 77 women (77%) whereas, control group included 24 men (24%) and 76 women (76%); no significant difference was encountered between the two groups with respect to gender (P=0.868). The level of Hs CRP in terms of median and inter-quartile range (IQR) in patients group was significantly higher than that of control group, 4.6 (4.9) versus 1.5 (2) µg/dl (P<0.001). There was no significant difference in the level of Hs CRP between men and women in patients group, 5.3 (5.7) versus 4.6 (4.8) µg/dl (P=0.680), as shown in figure 2. There was no significant correlation between age and level of Hs CRP in patients group (r = -0.056, P =0.581).
Conclusion: The present study showed that Hs CRP is significantly higher in patients with migraine headache and this may explain the inflammatory role in the pathogenesis and prognosis of migraine headache.

Abstract:
Background:
An intranasal surgical approach is often taken in reconstruction of the tip as a part of the cleft rhinoplasty. A rim incision provide maximal exposure to the nasal tip and usually obviates the need for external incisions.
The asymmetrical nasal deformity of unilateral cleft lip can be resistant to correction. All the components of the nose are involved; the cover, support lining and platform. Pathological anatomy of unilateral cleft nose includes (1) deflection of the nasal tip toward the side of the cleft, (2) posterior and inferior displacement of the dome of the alar cartilage on the cleft side, (3) an abuse angle between the medial and the lateral crura of the alar cartilage, (4) obtuse alar facial attachment, and (5) inward buckling of the alar on the cleft side. The alar-collumella web is unsightly and is difficult to correct in both secondary and primary surgery. The purpose of this article to improve the appearance of the nose by the correction of the alar web deformity in patients with unilateral cleft lip nasal deformities by introducing our cartilage graft technique inside the web.
Methods:
The article include 15 patients with alar webbing had underwent cleft lip surgery between May 2002 to July 2015. Most of the patient’s age are ranged between 13-25 years at the time of the surgery. The incision was an open rhinoplasty that including a reverse U shape incision. After that the cleft side was equalized with the dome angle of the healthy side, we use a nasal septal cartilage graft as a stiffy pattern to fix and stabilize the deformed converted web skin. The septal cartilage graft fixed to the cleft side web skin’s inner with (3-4) sutures to maintain the tackling of the vestibular skin.
The Results:
Many views basal and frontal are included postoperatively that have been showed, that the nostril and collummella had better shape. Our results showed that most patients demonstrated correction of the dropping alar and nasal tip and correction of the symmetry of the nostrils. The web cartilage graft was fixed to the deformed cleft side web skin’s inner with 3-4 sutures to prevent the tackling of the vestibular skin. Most of the patients have been followed up for a period ranged fro, 1-15 months.

Nanomaterial science hasemerged as a promissing field connecting different field togather. In this work, Gold and silvernanoparticles were prepared using a laser ablation technique.Nanoparticle solution was characterized using a UV-visible spectrophotometer, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Results revealed cytotoxic effects of Ag and Au NPs appear after long exposure time. These effects were enhanced by the irradiation of NPs after mixing with bacterial suspension. As a conclusion, Ag and Au NPs can be utilized as antibacterial agents under certain condition and with certain properties.

Abstract:
Background:
Bacteriophages represent important groups of viruses that drive the bacterial populations in the ecosystems directly and control their numbers, unlike antibiotics they can kill the bacterial host without damaging or any harm to the normal microbial flora, so bacterial resistance to antibiotics is no more valuable problem if the use of phages becomes more efficient in use.
Aim:
The purpose of this study was to isolate and characterizing the phages that able to infect methicillin resistant Staphylococcus aureus (MRSA) and determination of phages kinetics.
Methods:
Different techniques were used to isolate and propagate the MRSA phages, then phage kinetics were determined such as adsorption rate, eclipse period, burst size , phage host range, phage sensitivity to pH and temperature and the determination of phage nucleic acids.
Results:
Two types of anti-staphylococcal lytic bacteriophages primarily named Phage 1 and Phage 2 were isolated from sewage water. Phage 1 exhibited broad host spectrum it was lytic against all S. aureus isolates included for the study. Conversely, phage 2 have narrow host range as they could inhibit only 30 isolates, None of these phages inhibited a bacterium other than staphylococci species. The adsorption rate of Phage 1 was 2.1×10-10 ml min-1 while Phage 2 was 1.5×10-10 ml min-1. Eclipse and Latent periods of Phage 1 were 6, 13 minutes and for phage 2 were 8, 16 minutes respectively, the burst size of Phage 1 and Phage 2 were 83±15 pfucell and 37±10 pfucell respectively. Complete lysis time of Phage 1 particles was 4 hours while the complete lysis time of Phage 2 particles was 5 hours. Phages passaging results showed a remarkable increment in plaque forming unit (pfu) which were reached its maximal elevation at six passage in Phage 1 and fourth passage in Phage 2. Fitness of Phage 1 and Phage 2 were 22 ±5 pfucell and 20 ±2 pfucellrespectively through six generations. The Phage 1 and Phage 2 particles were stabled at a wide range of pH (6-10) and temperatures (30-50°C), the optimal temperature of two phages were 37°C.
Conclusion:
Overall findings suggested that MRSA phages are well distributed in the environment and represent a good and promising tool to control the infections result by this bacteria in which antibiotic resistance will be overwhelmed successfully especially in external infections such as burns and skins infections, which are safe and very specific with less side effects than antibiotic.

The study is designed to clarify the influence of induced maternal diabetes mellitus on placenta and the fetus at 18th day of gestation.Diabetes mellitus was induced in (24) female's rats (Rattusnorvegicus) before mating by streptozotocin (60 mg/kg of animal body weight) one dose intrapersonal injection, all animals were isolated and divided into two groups (non-diabetic and diabetic group), each group was composed of (12) female, also each group was subdivided into two groups, healthy females group as control and the subgroup treated with n-butanolic extract of celery seeds (60 mg/kg of body weight daily). The diabetic group also had been subdivided into two groups, another one of them had been treated with celery seeds extraction, and one had diabetes mellitus without treatment. There were many macroscopic observations reported by the current study, include the still birth in addition to differences in size between the fetuses which was tend to increased (macrosomia) in the diabetic groups resulted from hyperglycemic mother. Microscopic study detected harmful effects of diabetes mellitus on the tissues, while in the other hand there are a regeneration in islets of Langerhans when treated the animals with n-butanolic extraction of celery seeds with slightly heal in certain points in tissues, also had seen some of the side effects of treated with extract.

Abstract:
BACKGROUND & AIMS: Adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDS) on the upper gastrointestinal (GI) tract and small intestine are well described. Evidence is also accumulating that NSAIDS can induce and/or exacerbate the underlying pathology in the distal GI tract. The aim of this study was to estimate the effect NSAIDs on distal GIT
METHODS: In 79 consecutive patients with chronic user of NSAIDs and 50 matched controls were included in this study which is done in Aldewanyia city. A detailed clinical history and physical examination were taking. Sigmoidoscopy; with or without colonoscopy were done were done to all patients and volunteer candidates, with histopathological study of rectal and colonic biopsies
RESULTS: Of the 79 cases of patients, 38 (48%) were had lower clinical manifestation and 31(39%) of patients had histopathological which is mainly non-specific colitis vs. 9 (22%), 4(8%) of controls; P < 0.0001). NSAID use was aspirin (alone or combined) in 34.2% of cases, and 70.25% were using other NSAIDs alone or combined. Other independent risk factors were also assessed like smoking, diabetes, and body weight.
CONCLUSIONS: NSAID use is strongly associated with an increased risk of upper GIT. This review study point up that NSAIDs can cause significant morbidity in some patients ranging from changing of bowel motion, profuse diarrhea, exacerbating of underlying inflammatory bowel disease, to chronic blood loss with iron deficiency anemia. The pathogenesis is likely multifactorial and is thought to be related to inhibition of prostaglandin synthesis with direct effect of drugs or its metabolites.
The high prevalence of aspirin and other NSAIDs use suggests that adverse effects on GIT are increasing and should increasing the clinical awareness of these adverse effect throughout the GI tract may reduce morbidity. Concomitant NSAID use, smoking, and alcohol use is a widely association.

Abstract:Aims of study: The current study aimed to epidemiological identification and molecular detection of Cutaneous Leishmaniasisin Diwanyiah provinceby using the nested PCR method.Material and methods: The present study include (145) patient came to the dermatology lab. of Al-Diwanyiah hospital with suspected cutaneous leishmaniasis at period from (September 2016 to the April 2017). Epidemiological finding including study of age, sex and periods of infection, than, (50) suspected patient samples out of (145) patients samples undergo to performed Nested PCR technique, the frozen skin lesion samples were exposed to genomic DNA extraction step and Nested PCR was carried out by using specific primer forKinetoplast DNA (kDNA) for detection and identification cutaneous Leishmania species, such as L. major and L. tropica.Results:Our study shows infection of CLin the male(67) (46.2%) and the female(78) (53.8%) and it found Age (1-12month)(5) (3.5%) ; (1-10year):(42)(28.9%) ; (10-20year):(46%) (31%); (20-30 year): (19)(13.4%) ; (30-40 year):(14%) (9.85%) ; in more than 40 year(19) (13.4%); .Also the highest infection rate of CL were appeared during December 2016 (30.5 %), while the lowest were during April 2017 (2% ).The nested PCR was shown specific identification of cutaneous leishmaniosis. Where, the results shown (38) positive samples out of 50 samples at (78%) as cutaneous leishmaniosis. 28/38 positive at (73.7%) as L.majorand 10 /38 positive at (26.3%) as L. tropica.The nested PCR amplification was 560bp product size for L.majorand 750bp product size for L. tropica on Agarose gel electrophoresis. Conclusion:Cutaneous Leishmaniasisinfected both sex , all age and more prevalence in young patients with high infection rate during December. Both L. major and L. tropicawere the causative agents of cutaneousleishmaniasis but L.majorwas the main species in study area.

Abstract
Aim : Is to evaluate the effectiveness and practicability of Perineal Nerve Block (PNB ) in Anterior-Posterior Repair ( AP ) repair of the vagina for post operative pain
This study was a comparative study included 200 patients , divided into two groups . One received perineal nerve block ( PNB ) , and the other group did not receive. Pain score was used in both groups. Pain was severe in the group that did not receive the nerve block , while the group received PNB did not show significant pain.
Methods

Efficacy of PNB was prospectively evaluated on 200 consecutive patients over 24 months. 100 patients received LA ( Twenty ml of local anesthetic ( 10 ml 0.25% bupivacaine and 10 ml 1% lignocaine was infiltrated into both sides of the vaginal verge under General Anaesthesia ( GA ) to block the perineal nerve , and 100 patients did not receive PNB. Rescue analgesia in the form of tramadol and Intravenous ( I V )paracetamol was available.

Duration of analgesia ; post operative pain based on (VAS 0-10); and complications were analyzed.

Results: 200 AP repair surgeries were performed. Injection was done just after commencing GA , and 5 minutes onset time allowed before surgery started.
Operative time ranged from 25-30 minutes, and tramadol and paracetamolwere administered as rescue analgesia.
Post op pain based on VAS was assessed during the next 48 hours.
Injection site hematoma (3%) was the complicationsobserved.

Conclusions:
PNB is effective , simple and reliable analgesia in AP repair of the vagina surgery

Abstract
Background: The Neural tube defects NTDs refers to defect ocurr at birth resulting from defect in closure of the neural tube during early intra uterine life after conception; these anomalies are usually divided into cephalic and spinal forms. They include three main type , anencephaly, spina bifida and encephalocele , These NTDs are considered important causes of morbidity and mortality in infancy, childhood, and even young adulthood .
Objective: The aim of study is to study the type and incidence of the neural tube defect and it is it is risk factors and other associated variable.
Methods : This descriptive prospective study was carried on 120000 lived newborns from December 201 3 to December 2015 in al diwaniya teaching hospital , neurosurgical department and pediatrics hospital in al diwaniya province in south west Iraq ,the questionnaire include all the information's case were defined as women residing in the al diwaniya government , delivered live or still born with neural Tube defect . important feature related to the neonates and their parents like gender ,date of birth , type of neural tube defect ,father and mother age ,consanguineous marriage, drug take during pregnancy ,maternal diseases ,previous history of neural tube defect .

RESULTS :During a period of three years 2013-2015, there were (120,768 total ) birth ; the number of total births registered during the 3 years was 41761 in 2013, 39353 in 2014, and 39652 in 2015 . Among this sample population,112 women had fetus or newborn with NTD ( 1.078 per 1000birth ), An encephaly {3 (2.7%)} , spina bifida {103(92%)}, Encephalocele{6(5.3%)} Meningocele {20(17.9%)},Meningomyelocele {76 (67.9%)}, myeloschiasis {7 (6.2%)},The age of 112 women that her babies affected NTDs , 30(26.8%) had 16-25 years , 55 (49.1%) had 26-35 years while 27 (24.1%) had above 35 years .
Conclusion: This study showed that folate deficiency are very important in reducing the NTDs occurrences consanguineous marriage is not important risk factor for NTDs.

Abstract:
PCOS patients diagnose by having two of the following criteria: first oligo- and/or anovulation, secondhyperandrogenism (by clinical picture with or without biochemical features), and lastlyultrasound findings of polycystic disease.The underlying cause of PCOS is unknown. Theories about cause may include genetic predisposition. The role laparoscopic drilling for ovaries show advancing in treatment of PCOD in form of restore ovulation specially those patients in whom there is resistant to clomiphene citrate or incompliant for long term therapy.
Aim of the study: in this retrospective study we discuss the role laparoscopic ovarian drilling (LOD) in the correction of ovulation failure in PCOD patients showing primary infertility.

Patients and methods: This study includes 50 patients female, age between (22-35) years old.Inclusion criteria including period of infertility of 1–10 year duration, body weight increase with (BMI 29–35 Kg/m2),gynecological problems with abnormal mensturation, clinical pictures goes with high level of androgen hormone like acne vulgaris and hirsutism.
RESULTS: 50 patients were studied here .In 40 patients (80%), they show no menstrual cycle changes. Follow up period was 12 months.30 of patient (60%) had pregnancy; the mean time for the first pregnancy was 3.5months after operation.