Diyala Journal of Medicine

Background: In our studys the sample included 672 patient (348 male and 324 female
patients),who were attended the department of periodontics, school of dentistry University of
Sulaimani during one academic year (2008-2009).The sample was divided into subgroups
according to age and sex.
Aim: The aim of this study was to determine the number of patients and their chief
complaints, type of periodontal diseases, and to determine the number of patients from
outside and inside sulaimani city.
Methods: The clinical examination was recorded, including methods of detection of bacterial
plaque , according to the plaque index ( PL1) Sliness and Loe1964 ; gingival index ( G1)
according to Loe and Sliness1963;attachment loss (CAL); probing pocket depth (PPD).
Results: The questionnaires include general information such as, patients name; sex and
age; address, visit to dentist (regular visit, irregular visit) ; chief complaints (routine
checking; scaling & polishing; pain; bleeding; pre-prosthetic scaling and polishing; gingival
swelling; teeth hypersensitivity; halitosis ; esthetic). There was significant relationship
between: age groups and sex; patient age group and chief complain; male patients with
plaque induced gingivitis and male patients with chronic periodonities; male age groups and
visiting the dentist; female patients lived inside Sulaimani city and female patients lived
outside Sulaimani; age groups of total patients [male and female] and visiting the dentist. In
addition, there was high significant relationship between age groups and patients chief
complaints; age groups of male patients and type of periodontal disease; between female age
groups and type of periodontal disease.
Conclusion: Otherwise no statistically significant differences between male and female
patients; the address of male patient (inside and outside Sulimani),and patients with plaque
induced gingivitis and female patients with chronic periodontitis were found.

Background: Under different circumstances, adequate production of the semen specimen
followed by preparation for intrauterine insemination (IUI) is of utmost importance at many
centers. Cryostorage for 24 - 48 hours, could solve the problem of semen to the performance
of IUI. It is also advantageous if the male partner has difficulty in producing a semen sample
or not available at the time of IUI and reducing psychological pressure on the day of his
partner's aiming for repeating insemination after 24 hr.
Aim: The objective of this study was to investigate the beneficial effect of semen cryostored
at 5 degrees centigrade (5°C) for 24 hr by modifying Tris Solution (MTS) mixed with 30%
egg yolk (EY) on maintaining the functional and fecundity sperm parameters of patient`s
semen.
Materials & Methods: Thirty eight infertile patient`s semen samples (who was visiting the
High Institute of Infertility Diagnosis & Assisted Reproductive Technology (ART) for three
weeks) were involved in this study. Semen analysis was done for all samples as
recommended by (WHO Laboratory Manual for the examination of human semen and
sperm–cervical mucus interaction 1999). The patient`s semen samples were divided into two
groups; both groups were activated in vitro with FertiCultTM medium using the simple layer
method (SLM) for 30 min; a second group treated with (MTS) mixed with 30% (EY) and
cryostorage for 24 hr after activation.
Results: The results showed a highly significant (P<0.001) improved of all the certain sperm
function parameters of group 2 (cryostorage group) compared with group 1. It showed also
improvement of all parameters of infertile men semen. There was a highly significant
(P<0.001) increase in the percentage of grade A and grade B active sperm motility in group 2
compared with group 1.
Conclusions: It is concluded that the use of (MTS) with 30% (EY) maintains adequate sperm
viability and fecundity after 24 hr of cryostorage, and it was extremely recommended for
patients requiring intrauterine insemination (IUI) in different circumstances.

Background: Methionine supplementation is considered as one of the main factors inducing
hyperhomocysteinemia, which is thought to stimulate inflammation and increase the risk of
vascular diseases.
Aim of study: The purpose of the present study was to determine the effects of selenium, Nacetyl cystein and their combination on certain biochemical parameters and histological
structure of ovary and uterus.
Materials and Methods: Four groups (n=6) of female rats were randomly assigned to
receive a diet supplement containing (17gm/kg body weight) methionine, while the control
group n=6 for each group) were fed standard diet. In group 2, (1gm/kg body weight) N-acetyl
cysteine were fed with the methionine diet, while in group 3, (5ppm) selenium was added to
the water.
The combinations of all treatments (Methionine, N-acetyl cysteine and selenium) were
used in group four. After 5 weeks, all rats were dissected for biochemical tests including
determination of reduced glutathione (GSH) and thiobarbituric acid reactive substance
(TBARS) in sera, also histological evaluation performed in histological paraffin sections of
ovary and uterus.
Results: The data revealed a significant (P<0.01) elevation of TBARS and significant
reduction in GSH in methionine treated rats. The histological sections showed reduced of
ovarian follicles associated with infiltration of mononuclear inflammatory cells in
myometrium of uterus. Significant restoring of TBARS and reduced GSH levels were
produced by all NAC, selenium and combination treatments, except for selenium which
failed to decrease TBARS significantly. The developmental stages of ovarian follicles similar
to control rats were seen in combination group.
Conclusion: This finding explains the oxidative and toxic actions of methionine, and the
antioxidant activity of NAC and selenium, also it explains the synergistic therapeutic effects
of NAC and selenium combination.

Background: Molluscum contagiosum virus (MCV): is a viral skin infection which may
infect themucous membrane and skinoccasionally, It is caused by Molluscipox virus from
family Poxviridae. Molluscum contagiosumvirus (MCV) was first described and later
assigned its name by Bateman in the beginning of the nineteenth century.
Aim: This study was done to confirm the clinical diagnosis of MCV by laboratory test
through using PCR assay andto know the predominate type of MCV that found in Diyala
Province.
Patients, and methods:The present study was conducted for the period from1 November
2011 to 30 April of 2012 in outpatient clinic of Baquba Teaching Hospital in Baquba city.
The study aimed to confirm the clinical diagnosis of MCV by laboratory test through
using PCR assay and to know the domain subtype of MCV that found in Diyala province
Sixty (60) patients were diagnosed with clinical lesions of MCV on different areas of the
body, their age ranged from(1-80 years) including 40(66.7%) males and 20(33.3%) females,
and the lesion samples were taken and examined by PCR
Results: After testing by PCR, 51(85%) of patients gave positive results for MCV,30(58.8%)
patients gave positive results for MCV type 1( 26.7%) and 2 (73.3). The results showed
23(45.1%) with age group (31-40 years), included 36(70.6%) were males and 15(29.4%)
females, no significant difference showed between the MCV infection and either the sex or
age .
The results revealed that MCV type 2 was more prevalent 22(73%) compared with MCV
type 1(26.7) ,most of type 2 (73.3) infected males 14(46.5%) , and found in age group (31-40
years),while the MCV type 1 was equally affecting males and females , consisted of (100%)
in age ( ≤10 years) ,with significant difference recorded between the types and age, but no
significant difference between the types and the sex.
Conclusions: 85%of examined patients with MC showed postive PCR results for MCV
prevalence of MCV type 1 with high in children of age group (≤10) .MCV type 2 was
predominately seen in (31-40) patient age group.

Background: Assessment of sperm concentration as a component of semen analysis is one of
the most important steps in the evaluation of male in infertile couples so that
Oligozoospermia is a decrease in the numbers & density of spermatozoa produced by testes
(˂ 20 mill/ml). Speman is formulation of plant origin with no side effects and has been tried
for oligozoospermia, asthenozoospermia, enlarged prostate and azoospermia
Objective: To assess the effect of speman on
1-Pituitary –gonadal hormones 2-On the certain sperm parameters
Patient and Methods: A prospective study was conducted on forty oligozoospermic patients
attended the High Institute of Infertility Diagnosis and Assisted Reproductive
Technologies/Al-Nahrain University for period between first September 2011 to September
2012 , the mean age 35 years and with duration of infertility ranged between 1.5—12 years.
The patients were considered oligozoospermic if the sperm concentration was less than 20
million/ml according to WHO 1999 criteria . Speman drug was administered at a dose of 2
tablets, three time daily for three months. Semen analysis , particularly certain sperm
parameter( sperm density , motility and morphology) and Hormonal assay of serum levels of
testosterone , Follicles stimulating and Luteinizing hormones was conducted before and after
treatment .
Results: The results showed there was a highly significant (p˂0.001) which increase in the
means of sperm density (19.90 million\ml) it was observed after 3months of Speman
treatment. Regarding the sperm motility particularly grade-A was showed a
significant(˂0.05) improvement (31.87%) after treatment, and grade-A+B were improved (
50.27%) after treatment. The morphology of sperm was significantly (˂0.05) reduced
(31.50% )after treatment . The mean serum level of testosterone and Luteinizing hormone
were showed a significant (˂0.05) increased (6.24 ng\ml) and ( 3.98μIU/ml) after treatment
respectively.
Regarding its effect on follicle stimulating hormone were about 22.5% of cases shows
high serum level of FSH so that the speman , significantly (˂0.05) reduced follicle
stimulating hormone (5.69 μIU/ml) after treatment i.e. decreasing serum level by negative
feedback mechanism on hypo-thalamic-pituitary-testicular axis due to increase serum level of
LH which in turn lead to increase testosterone that causes decreased serum level of FSH.
Conclusion: speman may improve the sperm density , motility and morphology due to
improvement of testicular function and male accessory genital gland by influencing of
testosterone hormone which caused the serum level of FSH to be normal through feedback
mechansim and increasing serum level of LH.

Background: Abnormal uterine bleeding (AUB) is considered as one of the most common
and perplexing problems both to the patient and the gynecologist. Until the pathology
underlying menorrhagia is accurately diagnosed, proper therapy is hardly possible.
Objective: The objectives of the study were to determine the types and frequencies of
pathologies in endometrial curettings of abnormal uterine bleeding & compare different
endometrial pathologies in patient to age groups.
Material and Methods: a retrospective study in which H&E sections of endometrial
curretings of 152 patients were evaluated. Diagnosis was made by correlating the
morphological findings with the clinical history.
Results: Out of 152 cases of AUB, 61.8% were due to organic causes, while 33.5% were
dysfunctional in nature and seven (4.6%) specimens were insufficient for diagnosis. Of the
organic causes of AUB, Table (3), low grade endometrial hyperplasia was the most frequent
cause (41.5%) then pregnancy-related bleeding (31.9%). The most common histologic pattern
in DUB was proliferative phase endometrium 45.1%, followed by secretory pattern 21.6%.
Conclusion: Our study on endometrial curettings in abnormal uterine bleeding
revealed clustering of cases around Perimenopause.

Background: Pregnant women show an increased susceptibility to periodontal diseases
due to an exaggerated inflammatory response of gingival tissue to local irritant factors such
as ,dental plaque and calculus.
Aim: The aim of this study is to determine the prevalence and the severity of periodontal
disease at different stages of pregnancy.
Subject and method: The sample consists of (125) women from Private Clinic , Primary
Health Care Centre and Maternity Hospital in Sulaimani city, Kurdistan Region, Iraq . They
were divided into three main groups . Group one, which included (75) pregnant women and
this group was subdivided equally into three subgroups according to their trimester
(1st trimester , 2 nd trimester and 3 rd trimester). Group two, which included (25) women
receiving oral contraceptives pills , and match in age with group1 . Group three ( control
group), which included 25 women , and match in age with group 1 and group 2 , and the
following parameters were measured : Plaque index ( PL1); Ginigival index ( G1) ;
periodontal pocket depth ( PPD);Bleeding on probing(BOP); Gingival Crevicular fluid(GCF).
Results: The results showed high prevalence of gingivitis .The highest mean score of ( GI)
was found in the pregnancy group ; less in oral contraceptive group, and finally the control
group .Comparison between the (3) main groups showed significant difference.(p<0.05 ) .
GCF showed the same pattern as PLI and GI, and the total mean score was highest in the
pregnancy group ; less in oral contraceptive group and finally the control group. Comparison
between the 3 main groups declared significant difference ( p<0.05) similar to the PLI and
GI.
The highest percentage of PPD was mostly found in the pregnancy group and less in
contraceptive group .Comparison between the( 3) main groups showed high significant
difference, while between pregnancy and oral contraceptive decleared significant difference
( P< 0.05 ). The high percentage of bleeding on probing ( score 1) was found in the
pregnancy group, followed by oral contraceptive and finally the control group. There was no
prevalence of pregnancy tumor ( pregnancy epulis ) in the three subgroups of pregnant
women .
Conclusion: Major changes in clinical parameters ( PLI, GL, BOP, PPD, and GCF )
occurred during the 2nd and 3rd trimesters and to a lesser extent during contraception.

Background: Influenza A (H1N1) virus is the subtype of influenza A virus that was the
most common cause of human influenza (flu) in 2009. Other strains of H1N1 are endemic in
pigs (swine influenza) and in birds (avian influenza). In June 2009, the World Health
Organization declared the new strain of swine-origin H1N1 as a pandemic. This strain is
often called swine flu by the public media.
Aim : This study was designed to know case fatality rate and some demographic characters
during 2009 influnza pandemic among children in Al- Elwyia teaching hospital Baghdad
Iraq.
Methods : Cross sectional study of 342 cases with signs and symptoms of influenza were
studied. Samples were tested with real time polymerase chain reaction (PCR) .
Results :Case fatality rate was estimated to be 0.5% . Males and the age group of 6-12years
age group are predominantly affected with pandemic influenza.
Conclusion : Pediatric H1N1 case fatality rate is comparable to national and global case
fatality rate

Background: Pregnancy causes many changes in the pregnant women, due to mechanical
and hormonal changes which lead to ureteral dilatation and urinary stasis which contribute to
the increased risk of developing urinary tract infection.
Subject and methods: A cross sectional study was conducted at Al-Batool Teaching
Hospital in antenatal care clinic from March during October 2012 to study the epidemiology
of symptomatic and asymptomatic bacteriuria among pregnant women.
Results: out of 200 pregnant women who were included (24%) and (14%) with ≤20 years old
age group were asymptomatic and symptomatic respectively, and (56%), (64%) were
asymptomatic and symptomatic in age group 21-30 years old , while in those ≥ 31 years age
group was (20%) and (22%) asymptomatic and symptomatic respectively. The asymptomatic
bacteriuria was (77%) and it was higher among 31-40 weeks of gestation than other weeks of
gestations (p= 0.006).
The nulliparous was (27%) asymptomatic and (21%) symptomatic, where para1- para3 was
(56%) asymptomatic and (65%) symptomatic and para4 and above was (17%) asymptomatic
and (14%) symptomatic. Escherichia coli was (42.3%) more than other species.
Conclusion: Urinary tract infections is a public health problem, Routine urine culture test
should be performed on all antenatal asymptomatic and symptomatic pregnant women to
identify unsuspected infection.

Background: Breast cancer is a common malignancy and a major cause of death in women.
Many factors responsible for breast cancer such as viruses. Herpes simplex virus-1 (HSV-1),
infection which has been implicated in pathogenesis of certain disease and some studies has
been described the involvement of viruses in cancers.
Aim: To determine the presence of HSV-1antigen in women presented with breast cancer.
Methods: Twenty two formalin-fixed paraffin embedded breast tissue collected from the
Al-Kadhimiya teaching hospital in Baghdad. Clinical data were analyzed from the medical
records; in addition ten normal breast tissues used as control group. All samples were
sectioned and examined by direct immunofluorescence for detection of HSV-1 antigen.
Results: Detection of HSV-1 Ag in tissues patients with breast cancer was 31.8%
(7 out of 22), where statistical significant was found between expression of HSV-1 and
patients with breast cancer based on statistical analysis. While no significant correlation
between HSV-1 and age, grade, type of tumor and lymph node metastasis.
Conclusion: Based on the results of the current study, Herpes simplex virus-1 could be a
co-factor in the oncogenesis of breast cancer or could infect cancer tissues opportunistically.

Background: Wound infections are the most common hospital-acquired infections and are an
important cause of death.
Objective: This study was carried out to determine the isolation rate of different aerobic
bacterial pathogens from wound infections of hospitalized patients, and their antimicrobial
susceptibility patterns in Baquba General Hospital in Diyala province.
Materials and methods: This prospective study was conducted for six months from
November 2010 to April 2011 in surgical units of Baqubah General Teaching Hospital.
Wound swabs were obtained from hospitalized patients who developed wound infections and
processed in microbiology laboratory. Pus swab from each patient was collected aseptically,
and inoculated on culture media. Isolates were characterized, and identified, and Antibiotic
susceptibility patterns were determined using the Kirby-Bauer diffusion method.
Results: of total (100) swabs studied, (88%) were culture positive and (12%) were negative.
Staphylococcus aureus isolates were 34(38.6%), followed by Escherichia coli and
Pseudomonas aeruginosa were 28(31.8%), 24(27.3%) respectively. Both of Klebsiella
pneumonia and Proteus vulgaris were 14(15.9), Streptococcus pneumonia and Streptococcus
pyogenes were 12(13.6%), 4(4.5) respectively. The antibiotics susceptibility pattern for
Ciprofloxacin and Gentamycin were (78.5%), (69.2%) respectively, followed by
Streptomycin (43.1%) , Ampicillin (20%) and Amoxicillin (12.3%).
Conclusion: S. aureus and E. coli were the most common isolates from wound infections.
Ciprofloxacin and Gentamycin were the most effective antibiotics.

Back ground: Paliurus spina-christi methanolic extract is rich of phenolic compounds as
well as other biological active compounds (sugars ,esters, fatty acids and alkaloids) .
Aim:To asses that Paliurus spina-christi a good anti dermatophytic activity (Trichophyton
mentagrophytes) .
Materials and methods: five different concentrations of methanolic extract of P. spina-
christi against T. mentagrophytes followed by the RNA extraction of Ttichophyton
mentagrophytes grown in media containing P. spina-christi methanolic extract followed by
complementary DNA synthesis to examine the expression of Tri m4 gene .
Results: Statistical analysis revealed that at concentrations(25 and 50)µg/ml the differences
between means of the growth diameters are non-significant (P≥ 0.05) as compared with the
control while at concentrations (75,100,125)µg/ml the effect of methanolic extract on
diameter growth was statistically significant (P≤0.05). Maximum growth inhibition was at
125µg/ml while minimum inhibition was at concentration 25 µg/ml .The percentage of
inhibition was statistically significant especially at concentration 125 µg/ml it recorded 82%.
The expression of Tri m4 gene was identified in presence of extract .
Conclusion :Methanolic extract of P. spina-christi didn’t affect the expression of Tri m4
gene

The study was designed to find out the relation between lipid peroxidation, lipoprotein
levels to severity and complication of diabetes mellitus. Degree of lipid peroxidation was
measured in term of malondialdehyde (MDA) along with antioxidants, lipid profile and
blood glucose in type 2 diabetes mellitus. Total 400 human subjects, out of which 200
healthy individuals of age group ( 40 - 80 years) were taken as control and 200 diabetic
subjects of age group (40 - 80 years) were taken as cases.
The level of lipid peroxidation (MDA) increased as per the increase in concentration of
blood glucose as well as. There was significant increase in the lipid profile except HDL
cholesterol, which is decreased, also significant decrease in antioxidant vitamin E when the
major lipid soluble antioxidant vitamin presents in cell membrane and lipoproteins, which
may be due to their increased consumption during the process of combating excessive free
radicals generated in diabetes.

Background: exclusive breast feeding is recommended as the optimal way to feed infants
especially for the 1st 6 month of life. While the overall breast feeding rate are high in the
world all over, it is relatively uncommon among middle eastern women, there may be many
factors affecting that. The objective of this study was to identify if the parental (maternal &
paternal) education affect the using of breast feeding as the predominant way of infant
feeding in people of Diyala province as a trial for discovering the factors affecting breast
feeding practice in the society.
Patient & method: This is a cross- sectional study conducted at Al- Batool Teaching
Hospital for Maternity & Children from 1st of September 2011 – 1st of March 2012.
Children of 1 yr old or less were included, a detailed feeding history & the level of
education of both parents were taken.
The sample was divided according to the type of feeding into 2 groups: predominantly
breast fed babies & bottle fed babies, parental education level was divided into five classes.
Analysis of data was done by using SPSS version 10, chi- square was applicated to find the
association.
Results: During the 6 month period of the study, 61 pairs of children were included, 61 of
them were predominantly breast fed & the other 61 depended bottle feeding.
Chance of breast feeding was increased with increasing of both maternal & paternal level
of education, with p value of (0.07) & (0.011), respectively.
Conclusion: Mother’s education may add something positive in their mind towards breast
milk practice but it is not enough as a significant factor to encourage beast feeding. The state
was different with father’s education, it significantly affect the decision to feed their babies
breast milk.

Musculoskeletal hydatid cyst is very rare and represents less than 0.5% of all cases of
hydatid cyst. On clinical basis, infection mimics a soft-tissue tumor, and the preoperative
radiological diagnosis is very important to avoid biopsy.
A 35-year old male patient presented with a history of soft tissue mass and pain at the
medial aspect of the left mid thigh for the last 6 months. On physical examination, a mass
which was 13× 6 cm in diameter, was palpated over the medial aspect. Ultrasound scan
demonstrated loculated soft tissue mass with central cystic component in the muscular
compartnent of the thigh.
Histopathological examination revealed scolices, a cyst wall and a ‗germinal' layer confirm
which the diagnosis of hydatid disease. patient then put on medical treatment for one month .
This case illustrates that echinococcal disease should be considered in the differential
diagnosis of every cystic mass in every anatomic location, especially when they occur in
areas where the disease is endemic.