Diyala Journal of Medicine

Background: Breast cancer is one of the diseases that a woman may have to face during
her lifetime. Hormones play a role in breast cancer spread, determining the association
between plasma hormones and breast cancer risk may provide insight into the etiology of
breast cancer.
Objective: To evaluate the use of sex steroid hormone levels with some biochemical
parameters as a serum tumor marker in patients with breast cancer.
Materials and Methods: Two groups of subjects were included, 50 patients with
histologically confirmed diagnosis of Breast Cancer (group I) and 40 healthy female (group
II) the age range was (35-70) years were collected from Rizgary hospital and Nanakaly
hospital, in Erbil city, Iraq. During the period from May 2015 till November 2015. The
measured biochemical parameters included: the level of estrogen, progesterone, prolactin,
estradiol, testosterone hormones, some immunoglobulins (IgG, IgA and IgM), also ferritin,
sodium and calcium ions levels have been measured in the study.
Results: The results demonstrated significantly high values of steroid hormones (p<0.001,
p<0.01, p<0.002, p<0.05, p<0.05 (estrogen, progesterone, prolactin, estradiol, testosterone)
and significantly high values in immunoglobulins IgA, IgG, IgM in breast cancer in
comparison with control group. There were also high values of sera ferritin, sodium, and
calcium in women breast cancer in comparison with control group.
Conclusion: An elevation of serum steroid hormone, immunoglobulins (IgA, IgG, IgM),
Na, and Ca levels in cases of carcinoma breast in our study is signifies, and its importance
as a marker of the disease. A serial measurement of these steroid hormones and with some
biochemical parameters will have a prognostic significance and help treatment decisions.

Background: Tuberculosis is a highly infectious disease that primarily affects the lungs. It
can also affect other organs. TB was once called “consumption.” It is the world’s second-
most fatal infectious agent, after HIV/AIDS
Objective: To evaluate the effect of sodium nitrate, vitamin E and vitamin C administration
on liver enzymes, alanine transaminase, aspartate transaminase and alkaline phosphatase.
This research aimed to study the effect of tuberculosis (TB) on quality (QOl) of life of MDR
and non DR TB patients, it also to explore any possible association between getting MDR TB
and socio- demographic variables
Materials and Methods: A cross-sectional study was conducted in Chest and Respiratory
Diseases Center (CRDC) –Baghdad during 2015. The World Health Organizations Quality of
Life Assessment (WHOHQL-BREF) was used to asses QOL of 50 MDR and 50 Non DR
sputum positive pulmonary TB patients. Socio-demographic variables were studied. SPSS V.
22, was used in statistical analysis, Chi-square and Mann-Whitney-U tests were used to test
significance of differences, PV≤ 0.05 was considered significant.
Results: The mean age was 43.46 ± 14.8 and 37 ± 16.16 for MDR-TB and non-DR-TB
respectively. The age difference was significant (p=0.048). Males constitute a majority in
both groups (DR-TB 64% and non-DR-TB 59%). Smoking was higher in DR-TB than non-
DR-TB (57% and 38% respectively) and difference was significant (P =0 .016). Significant
differences between DR-TB and non-DR-TB in global QOL, global health, physical,
psychological, social and environmental domains (P=0.004, 0.014, 0.001, .0019, 0.001 and
0.001 respectively).
Conclusion: Patients with MDR-TB had lower mean scores than non-DR-TB for overall
HRQOL domains. There is association between getting MDR TB and being older in age,
lower educational level, smokers and being jobless.

Background: A wide variety of phenolic substances derived from spice possess potent
antimutagenic and anticarcinogenic activities. Some of these phenolic substances are
present in ginger, possessing strong anti-inflammatory and anti-oxidative properties as well
as exert substantial anti-carcinogenic and anti-mutagenic activities.
Objective: The aim of the present study to exam the protective effect of ginger extract on
Metronidazole (MT) induce bone marrow chromosomal aberrations and sperm
abnormalities, cell inoculated in male albino rats.
Patients and Methods: The present experiment included four groups of male albino rats.
The experimental group was administered five consecutive oral dose of metronidazole
(250mg/kg/day). The subsequent experimental group was administered ginger extract
(150mg/kg/day) for 9 days and on the 10th day Metronidazole (250mg/kg/day) was
administered for five consecutive days. For each experimental group a parallel control
group was maintained, one group administered 1ml of D.W. for 14 days the seconded
group administered (150mg/kg/day) of ginger extract for 9 days . Twenty two hours after
the administration of the last dose, rats were sacrificed for both chromosomal aberration
and sperm abnormalities.
Results: In animals treated with only mitronidazole there was a significant increases of
chromosomal aberration and sperm abnormalities. mitronidazole, beside other
chromosomal aberrations such as polyploidy, anuploidy were also observed. In comparison
to normal group animals were pre-treated with plant extract and subsequently treated with
mitronidazole and an overall decline in the mutation rate was also discernible clearly
indicating the protective effect of plant extract.
Conclusion: the results of this study indicate that metronidazole has the ability to induce
chromosome aberrations including (centromeric breake, centromeric gap, chromatid break,
centromeric fusion, polyploidy, aneuploidy and chromatid gap) in bone marrow cells and
sperm abnormalities in male albino rats. Ability of aqueous extract of ginger to reduce both
chromosomal aberrations and sperm abnormalities of mutated rats

Background: Cardiovascular disease remains the leading cause of mortality among both
men and women; heart rate is an important indicator of cardiovascular health. There are
few studies indicating that increasing level of obesity is associated with an elevated pulse
rate.
Objective: To assess the association between obesity and resting heart rate in our healthy
population, as both are regarded as risk factors for ischemic heart disease.
Materials and Methods: A total of 509 apparently healthy male individuals have been
selected by convenience method. An oxemeter device was used to investigate heart rate in
beats per minute, and saturated pressure of oxygen measured as percentage. Data entry and
analysis was done using Statistical Package for Social Sciences version 19. Chi-square was
used for categorical data analysis and a P value of ≤0.05 was regarded as statistically
significant.
Results: The results showed that 75% of overweight and obese participants have high pulse
rate (more than 100 b/m) with significant association between body mass index & pulse rate,
results also showed that the majority of overweight and obesity were between 40-60 years of
age with significant relationship between body mass index and age groups, no significant
association was found between association and Oxygen saturation.
Conclusion: High prevalence of obesity in this study was noticed. There was significant
association between resting pulse rate and BMI among males. No significant association
was found between body mass index and oxygen saturation among healthy males

Background: Coronary artery disease a dominant cause for morbidity and mortality. Risk
factors in the form of clinical data or biomarkers for atherosclerosis are useful for risk
stratification, treatment and prevention.
Objective: This study aims to assess the level of testosterone in stable atherosclerotic heart
disease and myocardial infarction compared to normal and effect of DM on testosterone in
ischemic heart disease in both stable ischemia and myocardial infarction.
Patients and Methods: In this cross sectional study a total number of 65 male patients were
taken. 35 patients with angiographically detected atherosclerosis and 30 patients admitted
with acute myocardial infarction that compared to 30 normal controls in Hawler cardiac
center during the period from 8th September 2014 till 2nd February 2015.
Results: The level of testosterone was 0.470 ± 0.655ng/ml in atherosclerotic coronary
arteries, 0.043 ± 0.008ng/ml in patients with history of acute myocardial infarction and
1.12 ± 0.29 ng/ml in healthy control male, which was statistically significant (P-value
0.002), diabetic patient had further lower testosterone level in all group.
Conclusion: Testosterone assessment may be beneficial in patients with recognized coronary
artery disease with no significant conventional risk factors and it could be a novel risk factor
.
if larger studies performed assessing testosterone level in atherosclerosis.

Background: Acute renal failure is a clinical syndrome in which a sudden deterioration in
renal function results in the inability of the kidneys to maintain fluid and electrolyte
homeostasis.
Objective: To study cases of acute renal failure in children below three years of age in
respect to etiology, presentation, laboratory findings and management.
Patients and Methods: A study of patients below 3 years of age with acute renal failure
admitted at Al-No’man teaching hospital and were followed up in Pediatric Nephrology
department in Al-Zahrawee hospital during the period from the 1st of October 2013 to the 1st
of October 2015.
Results: Forty patients with acute renal failure aging below three years old were included
in this study. There were 29 (72.5%) male and 11(27.5%) female children giving male to
female ratio of 2.6:1.Most common presentation was decreased urine output and acidotic
breathing. Most common complication was seizure in 6(50%) cases. About 14(65.6%)
cases needed peritoneal dialysis, 8( 34.4% ) cases responded to medical management,
while8(15%) cases died.
Conclusion: Acute renal failure in infants and young children below 3 years of age is not
uncommon.It is a preventable disease because most cases are due to pre-renal causes.
Prevention and rapid correction of severe dehydration may prevent acute renal failure and
consequent complications and death.

Background: Non-Hodgkin lymphomas (NHLs) are a diverse group of mature lymphoid
neoplasms with a wide range of cellular and histological presentations. Numerous
environmental and genetic factors affect the incidence of these neoplasms; however the
exact causes are beyond the current knowledge.
Objective: to investigate the association of genetic polymorphisms in two single nucleotide
polymorphisms, which are IL-10-1082A/G and IL-12p401188A/ C, with the incidence NHLs
among Iraqi patients.
Materials and Methods: Whole blood samples were collected from 55 confirmed patients
with NHLs and from 40 family-unrelated, age-matched apparently healthy individuals to
represent the control group. DNA was extracted from blood samples and allele specific
polymerase chain reaction (AS-PCR) technique was used for genotyping of the two SNPs
using specific primers.
Results: The SNP IL-10-1082A/G appeared in three genotypes: AA, AG and GG which
represented 36.36%, 45.45% and 18.18%% respectively in NHL patients compared to 32.5%,
35% and 32.5%% respectively with insignificant neither between genotypes nor alleles.
Similarly, the SNP IL-12p401188A/C had three genotypes which were AA, AC and CC.
These genotypes represented 32.73%, 38.18% and 29.09% respectively among NHL patients
and 52.5%, 37.5% and 10% respectively among controls with significant difference for the
homozygous mutant genotype (OR=4.667, 95%CI=1.319-16.512, P=0.017).
Conclusion: IL-10-1082A/G polymorphism has no effect on the incidence of NHLs, while
allele C o

Background: Deficiencies of coagulation factors have been recognized for centuries. The
most common inherited factor deficiencies are the hemophilias, X-linked diseases caused by
deficiency of factor VIII (hemophilia A) or factor IX ( hemophilia B).
Objective: To determine the clinical status, complications and the treatment regimen used for
the patients with hemophilia in Diyala province of Iraq.
Patients and methods: A review of all patient's records with hemophilia in the hemophilia
care center in Al-Battol teaching hospital in Baquba during the period from the1st January
2015-30th of June 2015 were included. The patient's records contain all the information
required such as age, gender, address, age at diagnosis, severity, presenting complaint, viral
status, presence of inhibitors and target joint involvement. All patients were tested to confirm
the diagnosis, assess the severity, viral status and the presence of inhibitors by factor assay,
activated partial thromboplastin time, prothrombin time, hepatitis B surface antigen, hepatitis
C virus antibodies, Human immunodeficiency virus serology and mixing study.
Results: A total of 64 registered patients were reviewed in the hemophilia care center in Al-
Battol teaching hospital of them 59(92%) with hemophilia A, while the others 5(8%) with
hemophilia B. All of them were male. With median age about 13 year and a range from 2 to
72 years. 20 patients(31%)with mild hemophilia ,11(17%)with moderate and 33(52%)with
sever type. Positive family history documented in 42 patient(66%) .One patient (1.6%)had
hepatitis B surface antigen positive test, with 9 patients (14.1%)with hepatitis C positive
results, no patients with HIV positive tests.3 patient(11%)with sever hemophilia A had
inhibitors.41 patient(64%)had target joint involvement.
Conclusion: Hemophilia is a rare disease but imply heavy impact on the family and the
society. The improvement in comprehensive care let those patients live longer with better
quality of life.

Background: Vaginal infections are common gynecological problem of women attending
consultancy clinics.
Objective: To find out the most common causes of vaginal infections among women in
Erbil city.
Patients and Methods: A cross sectional study carried out at the Consultancy Clinics of
Erbil Maternity Teaching Hospital through the period from 1st of July 2015 to 31st of
January 2016 on a convenience sample of 101 women in reproductive age attending the
clinics suffering from vaginal discharge. Vaginal specimen was taken from each woman by
sterile cotton with assistance of nurse, and was sent for culture and sensitivity test in the
hospital laboratory.
Results: Culture results showed growth of normal flora in 29.7% of women, bacterial growth
in 29.7% of women, fungal growth (Candida albicans) in 22.8% of women and mixed growth
(bacterial and fungal) in 17.8% of women. Bacterial infection was significantly observed in
vaginal discharge of women of older age group (p=0.005), rural residence (p<0.01) and
pregnant women (p=0.03). The main risk factors for bacterial vaginosis were use of non-
hygienic products (p=0.03), long marriage duration (p<0.001).
Conclusion: The study concluded that bacteria were the commonest cause of vaginal
discharge with and without fungal mixed infection.

Background: The newborn screening program is a public importance health service. The
early detection through newborn screening test facilitates transfer of affected infants for
timely treatment, stop disabilities, and mental retardation save lives infants, families, and
society, also it saves newborns from unnecessary invasive measures and families from
economic and emotional costs of diagnostic odysseys, it is therefore important to highlight
about newborn screening test.
Objective: Determine knowledge of mothers toward concepts related to genetic testing and
newborn screening test; also determine attitudes of mothers toward newborn screening test.
Materials and Methods: A descriptive cross-sectional study, by used modified questioner
by experts the data collection took place from the 15th December 2014 till 7th April 2015.
Twenty six primary health care centers have been chosen by multi-stage random sample,
with simple random sample technique to cover about 20% of all primary health care
centers from AL-Karkh and Al-Russafa sectors in Baghdad city. Total study sample was
566 mothers attending primary health care centers who had children aged between 3 days -
2 months. Data were analyzed through application (frequencies, percent's, mean of score
(M.S.) with their standard deviation (SD), relative sufficiency (R.S.%).
Results: The Results of the study show that all of the studied items were under cutoff point,
since mean of score, and relative sufficiency values show a failure response, about knowledge
of mothers toward concepts related to genetic testing and newborn screening test since their
mean of score values, as well as relative sufficiency's values are recorded under cutoff point.
The results show that all items have pass assessment of mother's attitudes toward newborn
screening test. Since their means of score, and relative sufficiency's values recorded extremely
upper cutoff point.
Conclusion: Mother's knowledge toward concepts related to genetic testing and newborn
screening test was failure. But attitudes of them toward newborn screening test were
(good) passing.