Al-Qadisiyah Medical Journal

Introduction:
pituitary apoplexy (PA), an uncommon clinical condition brought on by rapid bleeding or infarction. The primary symptom, a
sudden, severe headache, is occasionally accompanied by vision abnormalities or ocular palsy.
Aim of the study :
to assess the benefit of an emergent trans sphenoidal approach and its results, as well as the deficit of cranial nerves other than
the optic nerve in the recovery from pituitary apoplexy.
Patient and methods
A prospective study of cranial nerve deficit in pituitary apoplexy and their prognosis in patients with apoplexy followed up on
16 patients from 2018 to 2020 who had cranial nerve deficits throughout their hospital stays and for up to two years following
release.
Results :
Oculomotor nerve intracavernous segment has more predilection to involve in pituitary apoplexy cavernous invasion in our
study we include other cranial nerves to expel the presenting oculomotor nerve palsy in comprise to other cranial nerves and
even with mixed cranial nerve involvement, the cranial nerve involvement and cavernous extension and the volume of tumor
effect additional compression on cranial nerve. Only one patient with 3rd cranial nerve palsy and one patient with mixed palsy is
not recovered after six-month postoperative fellows while the majority retrieve their function during 1st three months.
Conclusion:
Patients with pituitary apoplexy who experienced ocular motility dysfunction due to cranial nerve palsies had favorable prognoses.

Background: Infertility is the inability of couples to achieve pregnancy after one year of regular unprotected coitus. Infertility
is the problem of 15% of young couples in different countries and male factor infertility accounts for 50% of cases. Melatonin
or 5-methoxy-N-acetyltryptamine was discovered by Aaron Lerner in 1958 while studying bovine pineal glands. Significant
advancements have been made in the research on melatonin, which has revealed its vital roles in regulating sleep-wake cycle
rhythms, decelerating the aging process, and functioning as an antioxidant or anti-inflammatory agent. Additionally, melatonin,
a critical component in reproductive functions, can eliminate free radicals such as (ROS).
Objective: The present study aims to evaluate the impact of Melatonin on male infertility.
Materials and methods: Serum melatonin was measured by using the Elabscience ELISA kit. A case-control study included the
fertile group as the control (n=40) and the infertile group (n=50). All the subjects were included in this study between October
2022 and June 2023. The diagnosis of the participants was executed by a medical senior based on clinical characteristics, the
history of patients, and biochemical tests. Age, family history, and BMI were measured. Blood samples were provided by each
participant for the biochemical estimation of serum melatonin, FSH, LH, and testosterone. While semen samples were collected
from each participant for the seminal fluid analysis.
Results: The results of this study showed a decrease in the level of melatonin in infertile men as compared with fertile men.
Moreover, there was no significant correlation between melatonin and FSH, LH, testosterone, and some semen parameters.
Conclusions: The study indicated that decreased melatonin levels can be associated with male infertility, but it did not indicate a
direct relationship between melatonin and hormone levels or specific semen parameters.

Background: Thalassemia is characterized by genetic abnormalities in the synthesis of hemoglobin, leading to a decrease or
missing production of one or more in the globin chains. Consequently, this disrupts the synthesis of hemoglobin molecules,
resulting in anemia, which is a prominent manifestation of thalassemia. Iron is an essential element for cellular health and is
involved in various functions, including oxygen transportation, biomolecule synthesis, respiration, and homeostasis. Hepcidin, a
low molecular weight peptide produced in the liver, plays a crucial role in regulating iron homeostasis.
Objectives: The current study aims to inspect the correlation of Hepcidin with Hemoglobin, Ferritin, and Iron Parameters in
Patients with Beta-Thalassemia Major.
Methods: The serum ferritin of all the subjects was measured by the ELFA technique (Enzyme Linked Fluorescent Assay). The
Serum Hepcidin was measured by the ELISA kit, and Iron, UIBC, and TIBC were measured via colorimetric methods.
Results: The {mean ± SD} of ages and genders among the patients and healthy groups were not significant. The {mean ± SD} of Hb
and serum levels of Iron, UIBC, TIBC, Hepcidin concentration, and BMI between the patients and healthy groups were statistically
significant. The study results of the correlation between Hepcidin and other markers in the beta-thalassemia patients group
showed a non-significant negative correlation of Hepcidin with TIBC and UIBC. While there was a non-significant weak correlation
between Hepcidin with Hb and Ferritin. The results also showed a non-significant positive correlation between Hepcidin and
Iron.
Conclusion: This study showed a marked reduction in hemoglobin production and high levels of Iron and Ferritin concentrations,
while the concentrations of TIBC and UIBC were observed to decrease in the individuals with this disease compared to the healthy
individuals. This study showed low Hepcidin concentration in the β-TM major patients compared to the healthy subjects.

Background: Type 2 diabetes is a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia) resulting
from the body’s reduced ability to produce or use insulin effectively. Insulin is a hormone that regulates blood sugar levels, and
in type 2 diabetes, the body either does not produce enough insulin or becomes resistant to its effects. This causes a buildup
of glucose in the bloodstream, which can eventually harm organs and tissues. This study was carried out on patients who
attended the Diabetes and Endocrinology Specialist Center of Marjan City for Medical Education in Babil Province., all patients
were diagnosed by a specialist physician. The practical side of the study was performed at the Clinical Chemistry Laboratory in
the College of Medicine and College of Biotechnology, Al-Qadisiyah University.
Objectives: Investigate the Correlation of Norepinephrine with some biochemical Parametric in patients with type 2 diabetes
mellitus.
Methods: The method used in this study Enzyme-Linked Immunosorbent Assay (ELISA).
Results: In the metformin treatment group and the group not using antidiabetic treatment, there are weak associations between
norepinephrine and insulin levels, but these associations are not statistically significant. In the diamicron MR treatment group,
norepinephrine is significantly correlated with lower levels of fasting blood glucose and HbA1c.
Conclusions: Norepinephrine dysregulation may be associated with type 2 diabetes, regardless of specific treatments, indicating
a potential role of norepinephrine in the pathophysiology of the disease

Background: Women infertility is a big health problem worldwide and genetic disorders are considered underlying causes of
unexplained female infertility. Objective: The current study aims to find out the role of miR-99a and TGFβ1 SNP (G/C +915)
in the development of secondary unexplained infertility in women and the prognostic of miR-99a. To achieve this goal, the
fold change of miR-99a had been measured by using Real-time PCR. In addition to the identification of TGFβ1 (G/C +915)
SNP by ARMS- PCR. Material and methods: The study is a case-control study which had been conducted by collecting blood
samples from a population including 50 female patients with secondary unexplained infertility along with apparently 50 healthy
controls. The samples were collected during the period from November 2021 to July 2022. The genomic RNA and DNA were
extracted from serum and blood respectively for molecular assay. Results: The mean of miR-99a fold change in the patients
group was 3.70 ±1.18 versus 0.84 ±0.34 in the control group and p < 0.001. TGFβ1 SNP +915 (GC) genotype CC was more
frequent significantly in the patients group than in the control group p < 0.001 and the OR was 19.06. While genotype GG
was significantly less frequent in the patients group than in the control group p = 0.046 and the OR was 0.22. Conclusion: The
present study demonstrated a diagnostic and prognostic value for miR-99a, since it showed high sensitivity 100%, specificity
98%, and accuracy 100% in secondary unexplained infertility, TGFβ CC genotype as a predisposing risk factor for developing
secondary unexplained infertility.

Background:. Escherichia coli infections represent a considerable burden in human. Illness caused by E. coli have a significant
burden on patients and the healthcare system, so prompt recognition, and appropriate treatment are necessary. Escherichia
coli is the first bacterial pathogen in humans responsible for deaths associated with antibiotic resistance
Aim of study: detection of hly, cdtI and stxI genes through molecular analysis in MDR E.coli isolates.
Methods: From November 2021 to May 2022, atotal of 150 urine samples were collected from patients suffering from urinary
tract infections were admitted and visit Maternity and Children Babylon Hospital in Al-Hilla city. 100 stool samples were (as
control). The identification and antibiotic susceptibility profile of E.coli were done by vitek2 compact system.The isolates were
subjected to PCR assays with specific primers for hly , cdtI and stxI .
Results: Only 50(45.5%) E.coli isolates were recovered from the urine samples. In contrast, 60(60%) E.coli isolates from the stool
samples. A high rate of MDR was detected among E. coli isolates, where it was( 60%) and (53.3%) in the uropathogenic and
intestinal isolates, respectively.
The PCR results were showed that MDR uropathogenic E. coli and intestinal E.coli were hardbourd hly gene (46.7%)and (90.6%),
respectively. The cdtI gene was detected in (43.4%) of uropathogenic E. coli, and (40.6%) of intestinal E.coli. The stx gene was
detected in (16.7%) of uropathogenic E. coli, and (43.7%) of intestinal E.coli.
Conclusion: The presence of a high percentage of toxin in intestinal E.coli is a serious warning because of the possibility of their
becoming virulent if the bacteria change their natural habitat or are exposed to a certain stress.

Background: The other most prevalent malignancy amongst females is breast tumour. A mammary tumour is a multi-step process
involving different cell categories, challenging to avoid internationally. Solitary of the finest methods to prevent mammary
tumours is by initial identification. Due to initial recognition, the 5-year comparative persistence ratio for individuals with breast
tumours is 80% in numerous developed countries. Together the appreciation of mammary tumours and the construction of
avoidance measures have progressed considerably in the previous ten years.
Objectives: Study the correlation of serum CA15-3, with ALT, AST, TSB, Blood Urea, Serum Creatinine, neutrophils, lymphocytes,
leukocytes, erythrocytes, thrombocytes, haemoglobin, NLR parameters in individuals with invasive ductal carcinoma.
Methods: The serum CA15-3 of all subjects was measured by the ELISA technique (Enzyme Linked Fluorescent Assay), ALT, AST,
ALP, B.Urea, S.Creatinine, as well as TSB were measured by colourimetric methods and neutrophils, lymphocytes, WBC, RBC,
PLT, Haemoglobin, as well as NLR measured by an Electrical Impedance Cell Counting methods ( CBC, automated machine ).
Results: The { mean ± SD } of Ages and Genders among Patients with healthy groups were not significant. There was no significant
variance in mean WBC count between the patients’ subject and control subject, However, the mean RBC count was significantly
lower in the patients’ subjects compared to the healthy subject, In addition, the mean haemoglobin level was significantly lower
in the patients’ subject compared to a control subject, There was no significant variance in mean platelet count between the
patients’ and healthy subjects, Moreover, the mean neutrophil count was considerably higher in the patients’ subject than the
control subject, However, the mean lymphocyte count was significantly lower in the patients’ subject compared to a control
subject, Therefore, the mean neutrophil/lymphocyte ratio count was considerably higher in the patients’ subjects compared
to the control group. Mean serum CA15-3 was considerably higher in individuals with invasive breast carcinoma compared to
a control subject.
Conclusion: the study results of the correlation among serum CA15-3 and other parameters in invasive ductal carcinoma of
the breast show a considerable positive correlation among CA15-3, and neutrophils, lymphocytes, haemoglobin, and NLR.
Moreover, there is a weak significance with AST and RBC, while there is no correlation between serum midkine and ALT, WBC,
TSB, B.Urea, and S.Creatinine.

Background
The recurrence and incidence of kidney stones are both high among Iraqi people. Previous studies offers details on the
diagnostics, pathophysiology, and epidemiology of kidney stone development, as well as techniques for assessing stone risks
in both follow-up and new patients. Recurrence of stones could be avoided with proper management and assessment. The
various dangers associated with each form of stone must be considered in the medical and dietary management of kidney
stone avoidance. The most effective means of preventing kidney stones from recurring are the identification of such risk factors
and the implementation of long-term management methods for dealing with them.
The study aims to determine the most prevalent risk factors that could result in urinary calculi.
Patients and Methods: In Al - Hussain Teaching Hospital in Karbala, 100 patients were diagnosed with renal stones after several
investigations, such as urine analysis Ultrasonography, and X-ray for kidneys, ureters, and bladders (K.U.B) participated in a
cross-sectional study.
Results: A total of 100 patients [31%] of whom were females, while [69%] were males, age group (36-45 years) made up the
majority of the participant age which was about 30%. This study found a significant association between gender and smoking,
over eating meat, potatoes, sugar or sodium, if the patient taking antacids, vitamin C, aspirin, or diuretics, if any relatives suffer
from stones, and body mass index (BMI) values association P<0.05.
Conclusions: There is an association between dietary habits of high sodium intake, eating animal protein, age, gender,
occupation, and family history with the occurrence of renal stone

In this study, 250 individuals with acute infection following surgical tooth extraction were treated at a Hilla dental clinic
and cultivated at 37°C for 18–24 hours. They cultured on several selective media at 37°C for 18–24 hours. Identification of
Streptococcus anginosus was based on colonial morphology, microscopically, and biochemical tests, and all scientific specimens
were successful cultures. Of 250 specimens, only 25(10%) were biochemically identified as Strep. anginosus, while 225(90%)
were associated with other microorganisms. Hemolysin-producing Strep. anginosus isolates have been studied. 10(66.66%)
isolates produced hemolysin in blood agar that formed a clearance sector around the colonies and a streak on the plate after 24
hours of incubation at 37°C. Strep. anginosus isolates were also tested for siderophores production, 5(33.33%) Strep. anginosus
isolates produce siderophores. All bacterial isolates provide protease to hydrolyze protein. After 24 hours of incubation, all
Strep. anginosus isolates were able to hydrolyze protein using protease enzyme (100%) when tested using M9 (supported by 20%
glucose and 1% csaien). Adding 3ml of 5% Trichloroacetic acid gave the colony a clean hallo. Quantitative biofilm development
tests were performed in a microtiter using Trypticase Soy Broth with 1% glucose. To improve accuracy, this assay was done three
times. All Strep. anginosus isolates were biofilm former (100%), 12/15(80%) were strong biofilm formers, and 3/15 (20%) were
mild biofilm formers. However, the antibiotic disc diffusion test using six clinically important antibiotics showed that most Strep.
anginosus isolates were extremely resistant to the antibiotics, especially the β-lactams, including Amoxicillin 13(86.6%), Cefixime
12(80%), Ceftriaxone 12(80%), Meropenem, 11(73.33%) Cefotaxime 10(66.66%), and Imipenem 9(60%).
Aim to study:
The study aims to test Streptococcus anginosus biofilm formation, hemolysin, siderophores, protease synthesis, and β-lactam
antibiotic resistance.

Laparoscopic Pyeloplasty with its pediatric application was first described by (Peters et al.,1995), from that time till now the surgical
hand skill has evolved lead to speed up the operation with Laparoscopy continue to show a preference for the transperitoneal
approach, but the feasibility of retroperitoneoscopic pyeloplasty has also been demonstrated effective results.
Aim of the study: To compare the Laparoscopic and Open Pyeloplasty in the management of Pediatric Patients with Ureteropelvic
Junction Obstruction.
Patients & methods: Multicentric comparative prospective study concluded from 1st of October 2018 till 1st of October 2020,
fifty patients enrolled in the study. 20 patients (12 male,8 female) undergo LP pyeloplasty with mean age is 11.5 years old in Al_
Diwaniya teaching hospital,30 patients (21 male,9 female) undergo OP pyeloplasty with mean age is 4 years old in Al_Diwaniya
teaching hospital and Al_Sader Medical city.
Results: The operative time in the LP group was found longer than the OP group (with a mean difference 30min.), with no organ
injury, no conversion to OP pyeloplasty, with comparable hospital stay between two groups, less pain, and better cosmetic’s
acceptance for LP group.
Conclusion: Short-term outcome of LP pyeloplasty is comparable to OP pyeloplasty regarding hospital stay, no organ injury, no
conversion, less analgesic requirement, and better cosmetics acceptance, which can consider promising gold standard surgical
intervention for the repair of UPJO nowadays particularly in pediatric patients