Diyala Journal of Medicine

Background: Prostate cancer is one of the major medical problems in male population.
Chronic inflammation has an important role in many human cancers and could be involved
in the etiology of prostate cancer. Toll-like receptors are important tolls in innate immunity
to pathogens. Many environmental factors could predispose for this cancer, however,
genetic background of the population cannot be neglected.
Objective: To explore the hypothesis that genetic variation in TLR4 gene can influence the
individual's susceptibility to prostate cancer.
Patients and Methods: A total of 95 outpatient men with histologically-proven prostate
cancer as well as 45 apparently healthy men were recruited for this study. Blood samples
were taken from each participant from which genomic DNA was extracted and TLR4 gene
was PCR-amplified, using specific primers. PCR products were genotyped by direct
sequencing.
Results: Asp299gly and Thr399Ile SNPs had only two genotypes; the distributions of these
genotypes were statistically not significant between prostate cancer patients and controls. At
allele levels, the control group had significantly higher frequency in the mutant allele of
Thr399Ile SNP (allele T) than prostate cancer patients. On the other hand, the rs11536889
had three genotypes with the mutant homozygous genotype (CC) and the mutant allele were
more prevalent in PCa than controls with significant difference (OR=3.433, 95%CI=1.107-
10.645, P= 0.033 and OR=2.730, 95%CI= 1.095-6.803, P=0.031 respectively).
Conclusion: Allele T of Thr399Ile SNP may have a protective role, while allele C of
rs11536889 SNP might increase the risk of prostate canc

Background: Maternal hemoglobin during pregnancy is well established to be contributors to
affect gestational age of newly born babies. Anemia is one of most prevalent nutritional
deficiency problem afflicting pregnant women in both developed and developing country.
Objective: To study the relationship between maternal hemoglobin during pregnancy and
gestational age of newly born babies.
Patients and Method: This is a cross- sectional study included 200 pregnant women
collected from Al- Batool Teaching Hospital for Maternity and Children, Baqubah city,
Diyala, Iraq, during the period between 1st of January 2014 to 1st of April 2014 delivered at
hospital. One hundred sixteen delivered by vaginal delivery, and eighty four were delivered
by caesarian section.
Result: Total number of cases 200 mother with their new born baby which delivered at
hospital hemoglobin of mother to anemic mother classified as severe anemia 4 (2.0%),
moderate anemia 19 (9.5%) and mild anemia 60 (30.0%) while normal mother hemoglobin
117 (58.5%). full term baby 157 (78.5%), preterm baby 38 (19.0%) and abortion 5 (2.5%).
Correlation between maternal hemoglobin and gestational age was in term baby with normal
hemoglobin 99 (63.1%) while anemic 58 (36.9%), in preterm baby with normal hemoglobin
15 (39.5%) while anemic 23 (60.5%) and in abortion with normal hemoglobin 3 (60%) while
anemic 2 (40%) which is statistically significant p-value = (0.03).
Conclusion: Low maternal hemoglobin levels are associated with increased risk of preterm
delivery

Background: Non-healing diabetic foot ulcers is a common problem worldwide, almost 15% of all
diabetic patients will develop one or more foot ulcers some of them will require amputation. Foot
infections are usually caused by aerobic gram-positive bacteria in the acute cases or a mixture of aerobic
gram positive, aerobic gram negative and anaerobic organisms in chronic wounds.
Objectives: To assess the efficacy of vinegar therapy on bacterial growth in the process of
treating diabetic foot ulcers.
Materials and methods: Retrospective comparison of changes in bacterial culture, necrotic
and total surface area of chronic wounds treated with either vinegar therapy or standard
(control) surgical or nonsurgical therapy. Total of 30 patients with non-healing ulcers were
divided into 3 groups; 10 wounds were treated with conventional therapy, 10 with vinegar
therapy, and 10 with hypertonic saline.
Results: Repeated measures ANOVA indicated no significant change in necrotic tissue.
During the first 14 days of conventional therapy, there was no significant debridement of
necrotic tissue, and heavy growth of different pathogens mainly Staphylococci, Streptococci,
and Pseudomonas. During the same period with vinegar therapy, necrotic tissue decreased by
an average of 4.1 cm2 (P = 0.02). After 3 weeks of therapy, conventionally treated wounds
were still covered with necrotic tissue over 41% of their surface and still growth of different
pathogens , whereas after only 3 weeks of therapy vinegar-treated wounds were completely
debrided (P = 0.001) and 70% of cultures were negative . Vinegar therapy was also associated
with hastened growth of granulation tissue and grater wound healing rates.
Conclusion: Vinegar therapy was more effective and efficient in debriding non healing foot
and leg ulcers in diabetic patients than was continued conventional care and associated with
lower bacterial growth rate

Background: Inherited bleeding disorders are rare diseases that are both complicated and
expensive to manage, they are classified into: coagulation factor disorders, vessel wall defect
and platelet disorders.
Objective: To show the pattern of Inherited bleeding disorders in Diyala-Iraq regarding
frequency, distribution and complications.
Patients and methods: A review of all patient's records with bleeding disorders in the
hemophilia care center in Al-Battol Teaching Hospital in Baquba during the period from the
1st of September 2014 to the 28th of February 2015 were included. All patients with a history
of bleeding tendency were tested to confirm the diagnosis. History and clinical findings were
recorded. Laboratory analysis included prothrombin time, activated partial thromboplastin
time, bleeding time, and fibrinogen assay. Patients with prolonged activated partial
thromboplastin time were tested for factors VIII and IX. If factor VIII was low, von
Willebrand factor: antigen and von Willebrand factor: ristocetin cofactor was performed.
Platelet aggregation studies were done when there was isolated prolonged bleeding time. All
patients were tested for viral infection such as hepatitis B,C and Human immunodeficiency
virus infection, patients with hemophilia A and B were evaluated for inhibitors.
Results: A total of 72 registered patients were reviewed in the hemophilia care center in Al-
Battol teaching hospital. Inherited bleeding disorders identified in these patients include
hemophilia A 57(79%), hemophilia B 5(7%), von Willebrand disease 5(7%), factor VII
deficiency 3(4%); and platelet function defects 2 (3%). There were 68 (94%) males and 4
(6%) females. Hemarthrosis was the most frequent complaint in hemophilia A and B
41patient (66%) with knee hemarthrosis in 29 (71%) of them. Viral hepatitis C was positive in
ten patients(14%), while hepatitis B positive in one patient(1.4%).The number of patients
with inhibitors to Factor VIII was 3(5.3%)from total number of patients with hemophilia A.
Conclusion: Hemophilia A, hemophilia B and vWD are the commonly encountered
inherited bleeding disorders in our governorate followed by other recessively transmitted
disorders.
Hemarthrosis involving knee joint was the most common complication. Inhibitor was
detected in a small number of patients.

Background: Electromagnetic radiation is the radiant energy released by certain
electromagnetic processes. Visible light is one type of electromagnetic radiation; other
familiar forms are invisible electromagnetic radiations such as radio waves, infrared light and
X rays.
Objective: To estimate the effects of static magnetic field and short wave ultraviolet on
different types of pathogenic fungi (growth of fungi, diameter and pigmentation of colony).
Material and method: This study was carried out at biophysics and microbiology research
lab, College of Medicine-Erbil, during the period from January 2010 till April 2010,
seven types of fungi were included, growing culture was examined carefully and colony
morphology was recorded, then preparation of slides from the colony was stained by Lacto
phenol or Gram stain. Examination were made on the fungi (Fusarium solani.,Penicillium
sclerotogenum, Candida albicans, Aspergillus parasiticus, Ulocladium spp., Penicillium
citrinum, Aspergillus tamari), they were isolated from the dusts, cultures were grown on
Sabourauds dextrose agar. The inoculums for our experiments were taken from the growing
zone of basic cultures.
All of these fungi are exposed to (375-750) gausses of static magnetic field and short
long wave ultraviolet at a periodic time (2,4,6,8,10,12,14,16,18,20,22,24.26) hours each days
respectively.
Results: The results of this study show that by using t-test there was significance difference
between experimental and control groups of fungi length after exposures to the mentioned
field at periodic times (2,4,6,8,10,12,14,16,18,20,22,24,26) day's respectively, shows that
there is significance difference between two groups after exposure to the (375-750) gausses of
static magnetic fields and none significance difference between experiments and control
groups of fungi after exposures to the short radiation wave and long wave of ultraviolet .
Conclusion: No change of dimensional length of fungi after exposure to short UV light, the
change which are caused in all types of fungi length after exposure to static magnetic field at
range (375-750) gausses

Background: Toxoplasmosis is a worldwide-distributed infection which is mostly
asymptomatic but can cause serious health problems in congenitally-infected newborns.
Objectives: Genotyping of Toxoplasma gondii and its distribution among aborted Iraqi
pregnant and its relationship with sero-prevalence of alpha-fetoprotein positivity among
toxoplasmosis cases.
Martials and Methods: Ninety six blood and amniotic fluids samples were collected from
aborted women that are suspected to have Toxoplasma gondii infection from 368 samples
collected from Al-Sadir Hospital, Al-Habibia Hospital, Al-Ilwea Hospital, Baghdad for
delivery Hospital, Al Khark Hospital, and Educational Laboratories of medicine City, during
the period from the 1st May 2014 till the end of June 2015.The results of aborted women
investigations were compared with those of 79 apparently healthy controls volunteers
pregnant.
Results: This study revealed that there is a highly significant increment in genotyping of
Toxoplasma Type II, [9(15.25%)], type I and III [2(3.38)]. While the distribution the
genotypes of Toxoplasma strains according to age groups showed that the highest frequency
(55.6%) of Type I was among those at age (15-25) years, while Type II was predominant
(39.6%) among the age group (36-45) years. For Type III, it was observed in very low
percentage among aborted (only 2 cases out of 96). The results showed a highly significant
difference in IgM level [48(93.8%)] among type II, [9(100%)] Type I, and [2(100%)] Type III
in comparison with healthy control (P<0.01). Moreover, the current results revealed a highly
significant different in Alpha-fetoprotein AFP positivity among [8(88.9%)], [46(95.8%)] and
[2(100.0%)] for Type 1, II and III respectively in comparison with [16(43.2%)] of healthy
control While level of AFP (P<0.01).
Conclusions: In view of the current results it could be concluded that type II strain was the
most common strain among the Genotypes. The genotype I the most deadly type, while type
III, which is an entero-zoonotic parasite recorded for the first time in Ir

Background: C-reactive protein is a well-recognized acute phase reactant that is greatly
involved to support the diagnosis of neonatal septicemia.
Objectives: To high light the correlation between C- reactive protein and neonatal septicemia.
Patients and Method: A cross sectional study on hundred neonates infant demonstrated to
have sepsis were studied during the period from 1st October 2014 to 28th February 2015.
One group study was evaluated; age ranged from 29 week gestational age to 29 days post-
natal. The data of patients in the group study collected from Al- Batool Teaching Hospital for
Maternity and Children - neonatal intensive care unit.
Result: There were 100 patients included in this study; that 61 patients (61%) were pre term
(29 to 36 weeks gestational age), 39 patients (39%) were full term 37 weeks’ gestational
weeks - 29 days post-natal).
Males were 56 (56%), and females were 44 (44%). Fifty-seven (57%) were delivered by
vaginal delivery; were as 43 (43%) delivered by caesarian section. The C- reactive protein
level correlate well with the diagnosis of the neonatal sepsis as 86 (86%) patients had a
positive result versus 14 (14%) who had negative results.
Conclusions: C-reactive protein is very useful, cheep, and available test to confirm the
diagnosis of neonatal sepsis and to follow the response of the patients to the antibiotic
treatment.

Background: Coronary artery disease is one of important diseases as in many cases ends up
with death. Among many types of coronary artery disease is the lipoprotein plaque deposition
on the artery wall. Many reports appeared in the literature concerning the causes,
investigation, and treatment of the coronary artery disease. As computed tomography
scanners were developed, a new non-invasive procedure was introduced using the calcium
present in the plaque as an indicator for the amount of plaque in the coronary artery.
Objective: To investigate the validity of the calcium score in the diagnosis of coronary artery
disease, and also to find the relation between calcium score with calcification and plaque.
Patients and methods: Sixty one patients 40 were men and 21 were women evaluated for
calcium score. They had symptoms of chest pain and were subjected to electro cardio gram
examination to determine their eligibility for computed tomography angiography to
investigate the coronary calcification as a marker of atherosclerosis.
The history of diseases including hypertension and diabetes were recorded and check renal
function test. Anthropometric measurements and the level of fasting lipid profile for patients
and normal subjects were tasted.
Patients were advised to come fasting prior to the examination. They have been given Beta
blocker to reduce the heart rate in the range of 55-65 beats/min. Contrast medium was
injected IV by means of injector immediately before scanning.
Results: Results revel that not all patients suffering from chest pain with electro cardio gram
changes show high calcium score; on the other hand patients with high calcium score they
have an increased plaque in their coronary artery. At low calcium score calcium score
(0-100), cholesterol, triglyceride and high density lipoprotein are generally inversely
proportional with calcium score with the exception of LDL remains virtually unchanged
throughout the whole range of calcium score (0 > 300) as appear in the figures . While at high
calcium score concentration (>300) lipoproteins are directly proportional with calcium score
in contrast with high density lipoprotein which is inversely proportional with calcium Score

Background: Trace elements are essential for life and their concentrations in serum vary with
human ecology and different pathological conditions. Several studies have pointed out
associations between various metals and cardiovascular disease.
Objectives: To evaluate the effect of serum metals such as: nickel, cobalt, cadmium, lead and
mercury in patients with angina pectoris and compared to healthy individuals.
Materials and methods: The studied consist of 100 volunteers with age range 40-65 years,
50 healthy individuals compared with 50 patients with angina pectoris in order to investigate
the following serum parameters: serum lead, nickel, cobalt, cadmium and mercury levels, and
lipids profile test [total cholesterol, high density lipoprotein, low density lipoprotein and
triglyceride.
Results: Circulating levels of serum lead, nickel, cadmium (p<0.001), cobalt (p<0.05) and
mercury (p<0.007) were significantly higher in patients with angina pectoris than in healthy
controls, while high density lipoprotein was decreased (p<0.05) and triglyceride, total
cholesterol and low density lipoprotein were increased significantly (p<0.05) in patients
angina pectoris compared with normal control.
Conclusion: In this study high levels of heavy metals (cadmium, lead, nickel, cobalt, and
mercury) were detected, which may play role in the genesis of angina pectoris, and this may
be due to the main sources of contamination (dependent on the metal) are industry, traffic,
tobacco consumption, and agriculture/nutrition. While lipoprofile such as total cholesterol,
triglyceride, high density lipoprotein, and low density lipoprotein which may play role in
genesis of angina pectoris.