Diyala Journal of Medicine

Background: Living organisms are permanently exposed to internal and external factors that
damage DNA. This damage, if not repaired, can lead to the mutation which cause verius
diseases and cellular death. Therefore,the use of many plants or their products has been
adopted as aprotective material against genetic toxicityof certain drugs.
Objective:Examined the susceptibility of both metformin and pollen grain solution to the
prevention of damage in octa4 gene and mitomycin C, In order to be adopted as materials
available and cheap to prevent damage to genetic material and the result of the use of human
drugs.
Patients and Methods: was used 25 white males rats for 4 weeks obtained from the College
of Veterinary Medicine / University of Baghdad and ages ranging from (10-12) weeks. The
rats were divided into 5 groups. the control group was drip with distilled water as well as
injected The second group was treated with mitomycin (0.001ml) was injected
subcutaneously weekly for 30 days.while the third group was orally injected with metformin
with a concentration of 500 mg / kg with mitomycin , while the fourth group was treated
with mitomycin and water solution for pollen at 0.1 g / mL per animal. while the fifth group
included rats treated with mitomycin with metformin and water solution for pollen. The
animals were anesthetized and the kidney and liver were removed. The DNA extraction
process was investigated and the presence of the octa4 gene was investigated using a special
technique and PCR technique.The tissues like liver, kidney and testies were collected for
study the expression of Oct 4 gene.
Results: The C. papyrus pollon extract along with metformin is effective against mitomicine C
induced animals. Oct 4 it has been protected from mitomycin damage in both the kidney and
liver tissue compared to the testis of the animals treated with C. papyrus pollon extract and
metformin. C. papyrus pollen grain producing an effective and safe product, and further
research is required in addition to the aggregate value to the native plants.
Conclusion: In the present study, C. papyrus pollon extract along with metformin is
effective against mitomicine C induced animals. Oct 4 expression was significantly higher in
the kidney and liver tissue of the animals treated with C. papyrus pollon extract and
metformin. The result of the present study clearly indicates that C. papyrus reduces blood

Background:Breast cancer (BC) is the most common malignancy in Iraqi women in the
recent years. There are many indicated marker for detection BC and determination the
development of the tumor stage, one of the most important marker is human epidermal
growth factor receptor-2 (HER2).
Objective:To evaluation of serum and tissue HER2 levels among BC women and non BC
women.
Patients and Methods: Preoperative blood samples were collected from breast cancer
women. Patients were newly diagnosing and did not receive neither radiotherapy nor
chemotherapy treatment preoperatively.For the control, blood sample was collected from
non-breast cancer women. All blood samples subjected to determine the serum HER-2 level.
Results: A total of 52 patients with breast cancer and 30 of control were included in this study.
The result showed increasing significant in serum concentration of HER-2 among BC patient
compared to control and tissue her-2 positive BC patient have significantly higher serum
concentration of HER-2 compared to BC patients who were tissue her-2 negative (16.23±10.37
ng/ml, 10.33±5.73 ng/ml) respectively.
Conclusion: Serum HER-2 level was positively associated with tissue HER-2 level, for that
is an important marker for diagnosis and monitoring BC progression.

Background:Cardiac manifestation including heart failure, arrhythmia, and pulmonary
hypertension are well recognized among β-thalassemia major patients.Pulmonary
hypertension is responsible for about half of their mortalities yearly.
Objective:To estimate the prevalence of pulmonary hypertension and identifying the risk
factors among β-thalassemia major patients.
Patients and Methods: A cross sectional study was carried out in Thalassemia Center and
Rizgary Teaching Hospital in Erbil-Iraq during the period from 1st of April to 31st of
December, 2017 on a convenient sample of 100 patients with β-thalassemia major. The
prevalence of pulmonary hypertension was determined and the diagnosis based on
Echography findings.
Results: Pulmonary hypertension was observed among 31% of β-thalassemia major patients.
The prevalence was significantly related to age, history of splenectomy, improper chelation
therapy and obesity, as well (p value =0.04, 0.01, 0.03 and 0.01 respectively). Moreover; the
severity of pulmonary hypertension was significantly associated with older age (p= 0.007) and
mean lower ejection fraction (p <0.001).
Conclusion:The prevalence of pulmonary hypertension among our patients with β-
thalassemia major is within acceptable range.

Background:Obesity in children and adolescents is one of the most serious public health
challenges of the 21st century because of the effects of future morbidity. Its prevalence has
increased significantly in mostcountries,especially in low and middle-income countries,
especiallyin urban areas.
Objective: To know the distribution of this epidemic among our childrenand draw a real
picture of intermediate school students in Baladrouzregion.
Patients and Methods: A cross-section study, involved the students of the first and the
second stages, the information and the measurements were taken from 1798
students(910males, 888females) their ages were between 11-14 years , over one month
duration (December of 2017), during this period we visit a were 10 Intermediate schools for
both genders (six of them in the center of the region and four in the surrounding villages
those belong to the region), included the age, weight, height, counting the body mass index,
waist circumference, Neck circumference, systolic blood pressure and diastolic blood
pressure in addition to the questionnaire form and the information of the school card.
Results:The percentages of the overweight and the obesityamong males were as follows:26.9%
,17.4 % for intermediate, first and second stages respectively, while in females it was 47.9%
,33.3% respectively .The percentage of weight gain and central obesity of the waist
circumference was27.0% ,24.1% for the first and second stages respectively. Either in femals,
as follows:21.5%, 12.8% for the first and second stages respectively. There was an increasing in
the percentages of systolic blood pressure among female for all stages of the study,which
amounted to 60.3%,48.7% either in males was 70.4%,64.8%for the first and second
stagesrespectively.The percentage of normal diastolic blood pressure was 54.5%49.0%for
males, while infemales it was 72.5%,65.7% for the first and second stages respectively.
Conclusion: The study showed high rates of overweight and obesity among middle school
students, and was higher in females than males.

Background:Coronary artery disease is the leading cause of premature death in the
developed world and is estimated to become, by 2020, the major cause of death worldwide.
Objective:To Evaluate the role of interleukin 6 and acute phase proteins in
immunopathogenesis of myocardial infarction.
Patients and Methods: This study was conducted in Baquba Teaching Hospital in Diyala
province .Ninety blood sample were collected from patients with myocardial infarction, 62
(68.9%)were males and 28 (31.1%) were females with age range (25-90) years, control group
(35) patient, a males were 28 (77.14%) , and females were 8 (22.86%) with age range (25-70)
years.
Results: The results showed levels of Interlukine-6 was higher in patients (47.44 ± 30.50) pg /
ml than control (37.13 ± 12.08) pg / ml with no significant difference and the positivity of C-
reactive protein in patient group was (81.3%) than control group was (0%) ,with highly
significant different , the level of C3 and C4 in present study was lower in patient than control
group.The C3 complement level was (112.88) pg / ml which is lower than control group
(121.48 ±) pg / ml ,while C4 level was (19.73) pg / ml also lower than control group (26.81) pg
/ ml and significant difference was noticed among C4 .
Conclusion:We concluded that there is high level of IL-6 in patients with myocardial
infarction and significantly high levels of C-Reactive Protein in patients of Myocardial
infarction while showed there are low concentration levels of C3 and C4complement in
patients with myocardial infarction.

Background:Community-acquired pneumonia. is a disease in which individuals who have
not recently been hospitalized develop an infection of the lungs, which can affect people at
all ages. Pneumonia affecting about 2/1000 of the population per year.The initial assessment
of the severity of community-acquired pneumonia is important for patient management.
Severity assessment is an important early step in the management of patients presenting with
community-acquired pneumonia. Various pneumonia-specific scores, generic sepsis scores
and predictive biomarkers have been proposed as tools to aid clinicians in key management
decisions.
Objective:The study was conducted to determine the efficacy of CURB-65 in the
management of the Pneumonia.
Patients and Methods: 200 consecutive patients attending Baquba Teaching Hospital
(108 female and 92 male) at a median age of 68 year , male(46%) and female(54%)
between April 2017 and November 2018, diagnosed as CAP .
Results: CURB65 is useful in the evaluation of patients with CAP and determining the severity
of the illness a clinical prediction rule suitable for use in busy casualty departments or
admission units.
Conclusion: Iit include clinical features of prognostic importance, which were easily
measurable at the time of initial assessment.

Background: H. pylori has been established as the major causative agent of chronic gastritis,
and represents the main etiological cause of other gastroduodenal diseases such as peptic
ulceration, gastric lymphoma, and gastric cancer. Therefore, screening and treatment of the
bacterium is an important strategy for preventing gastric cancer.
Objective: To compare some invasive classical histological tests to non-invasive serological
antibody and stool antigen tests for the diagnosis of H. pylori infections.
Patients and Methods:The study population comprised of 171 patients with symptoms of
dyspepsia and other gastritis related symptoms. Three biopsy specimens were taken and
collected from the stomach and sent for histopathologic study. H and E staining and modified
Giemsa staining were performed on tissue sections of each case. Serology antibody and Stool
antigen tests were also used as nan-invasive tests in this study.
Results: Four tests had been done to detect the presence of H. pylori Bacteria. The mean age (+
SD) of the studied sample was 43.8 + 14.7 years, ranging from 20 to 74 years. The median was
44 years. The total agreement between the serum Ab test and the stool Ag test was 88.3%.
Significant differences were detected between the two tests (p < 0.001). It is evident that the
serum Ab test is highly sensitive (sensitivity = 98.4%), but the Predictive value positive (76.3%)
was not so high. The Giemsa test was highly specific (specificity = 98.2%), and highly sensitive
(sensitivity = 93.5%).
Conclusion: The main advantage of histopathology tests is not only restricted to detection
purpose, it also can detect any abnormalities of gastric mucosa by bacteria such as peptic
ulcer bleeding, atrophic gastritis, intestinal metaplasia, and gastric cancer. The modified
Giemsa staining method could be used as a method of choice for the detection of H. pylori
due to its sensitivity, simplicity and consistency.

Background: Bilirubin associated brain damage is great in the preterm and low birth weight
newborns. Phototherapy is able to control the level of bilirubin in low birth weight newborns.
Objective:To show the role of prophylactic phototherapy in the management of very low
birth weight newborns weighting(1-1.5)kg with hyperbilirubinemia in comparison to
therapeutic method.
Patients and Methods: Across sectional study; Very low birth weight newborns weighting
(1–1.5)kg were included in the study and admitted to neonatal care unit because of their very
low birth weight and family consent had taken about admission and prophylactic
phototherapy from some families so the total number of newborns was forty, twenty
newborns were received phototherapy within nine hours of birth and lasted for seven days
while twenty newborns were received phototherapy when indicated according to birth weight
and continued to seventh day after birth , analysis was made for mean daily bilirubin level ,
duration of phototherapy , peak bilirubin level in the prophylactic and therapeutic groups and
blood exchange need.
Results: The highest daily mean level of total serum bilirubin(TSB) of prophylactic group was
6.5±0.4 mg/dl, which happened on the fifth day. In the therapeutic group, it was 8.7±0.5 mg/dl
on the fifth day after birth. There was significant difference in the TSB values of prophylactic
group which was less than that of therapeutic group from second to sixth days( p<0.0001). The
median duration of phototherapy in the treatment group was shorter than that of the prophylactic
group.
Conclusion: Prophylactic phototherapy in very low birth weight preterm infants weighting
(1-1.5) kg can significantly decrease jaundice after birth compared with the therapeutic
group, also this study indicate that there is significant high TSB level among males in both
groups in comparison to females

Background: Molar pregnancy (hydatidiform mole HM) is an abnormal form of pregnancy
in which a non-viable fertilized egg implants in the uterus and will fail to come to term. A
molar pregnancy is a gestational trophoblastic disease which grows into a mass in the uterus
that has swollen chorionic villi. These villi grow in clusters that resemble grapes. A molar
pregnancy can develop when a fertilized egg does not contain an original maternal nucleus.
The diagnosis of HM is based on its morphology. In classic cases, the abnormally large villi
have a vesicular or a grape like appearance. Histologically, HM presents variable degrees of
circumferential trophoblastic hyperplasia and epithelial atypia. Distinguish between complete
mole (CM) and partial mole (PM) is difficult especially with early diagnosis and evacuation
of molar pregnancies, however, the criteria are subjective and show considerable inter-
observer variability. Unfortunately in our country the histological diagnosis is depend only
on routine stain (H&E) which is not giving a clear results in some cases because of that, the
study design to find the similarities and differences between the two types of molar
pregnancy by using some of special stains which surely distinguish between complete and
partial moles samples using immunohistochemical marker P57KIP2.
Objective: To detecting if the special stain can be helpful to distinguish between the two
types of molar pregnancy also to find the accuracy of the routine diagnosis of hydatidiform
mole comparing with P57 immunohistochemistry stain.
Patients and Methods: The study conducted at the maternal teaching hospital in Erbil city.
Thirty cases of Molar Pregnancy diagnosed, 15 of them were complete and the others were
partial mole. All the samples studied histologically using H&E and some of special stains
including: PAS stain, Congo red, and Trichrom, to describe the morphological differences
between the two types of mole. Also immunohistological P57 stain was used in this study to
confirm the type of mole.
Results: The study result shows the morphological variation between complete and partial
hydatidiform through using the routine H&E stain and special stains. The complete
hydatidiform mole sections showed vesicular swelling of chorionic villi and circumferential
trophoblastic hyperplasia, the trophoblastic proliferation grade varying in complete samples,
most samples showed grade II (46.6%) of trophoblastic proliferation, while few of samples
showed grade III (13.3%). The cases of partial hydatidiform mole showed scattered hydropic
villi with irregular scalloped villous outlines and mild trophoblastic hyperplasia, trophoblastic

Background:Diabetes mellitus is a chronic disease began when there is essential
insufficiency of insulin that produces by the pancreas, sometimes by the incompetence of
that insulin. Such as insufficiency lead to elevate blood glucose concentrations, that in
sequence impairment many human body. There are two main types of this disease, our study
will be on type 1diabetes mellitus. Type 1 diabetes which called insulin-dependent diabetes
mellitus in this type the pancreas be unsuccessful to produce the insulin. Type1diabetes
milltus progress commonly in children and young people, type 1 diabetes is described by
presence of mixing autoantibodies against variation of insulin antigens, such as Insulin
autoantibodies,Glutamic Acid Decarboxylase Autoantibodies.
Objective:To estimate the most autoantibodies and assessment of HbA1c in type 1 DM.
Patients and Methods: This study was conducted at in AL-kindy Teaching Hospital-Center
of Endocrine glands and diabetes Mellitus For the period 1/7/2016 until 1/2/2017, The study
included (75) individual divided into (50) diabetic patients( 25 female and 25 male) their
ages ranging between 10-45 years and(25).Healthy persons (11 female and 14 male) and
there was questions for each patient about( Age, Family history, Onset of
disease\years.)Quantative ELISA test for detection of circulating autoantibodies against
Glutamic Acid DecarboxylaseزIndirect immunofluorescence test to detected insulin auto
antibodies in human serum, and measurements level of HbA1c for each subjects.
Results: The results of this study indicate importance of autoantibodies to identify a group of
type 1 diabetes mellitus patients.This results showed significant difference in the prevalence of
autoantibodies in diabetes mellitus type 1 patients (P<0.05) .There was significant association
between Insulin and Glutamic Acid Decarboxylase Autoantibodies. and onset of type
1diabetes mellitus, These autoantibodies are more occurrence in earlier affected type 1
Diabetes Mellitus patients . No correlation between gender and diabetes type 1 non significant
difference (P>0.05).
Conclusion:There are many cases of Diabetes Mellitus identified by laboratory
investigation only ; whom are asymptomatic, screening tests had supportive for quick
detection and treatment.

Background: Cancer is one of the major human problems and breast cancer is a significant
health problem. In spite of the developed treatment methods, breast cancer cannot be treated
very effectively. Therefore, the identification of novel genes that will have played a role in
the treatment and diagnosis of breast cancer and the high interest of B-cell lymphoma
(BCL2) family proteins are critical regulators of apoptosis).
Objective: The current study aimed to investigate the relationship between the levels of
BCL2, BAX, and B-cell integrate medium (BIM) proteins which the prognosis and apoptosis
processes of the breast cell line.
Patients and Methods: Collected tissue samples from normal and cancer tissue type, RNA
isolated from the cell, then quantitation done, cDNA synthesized, cDNA quantitation and
Real-time PCR was performed to see the level between two kinds of genes.
Results: BCL2 protein level was significantly lessened in regulator molecule tissues of a cell
line with breast cancer. In contrast to Bax protein, no significant difference was detected in the
BIM expression level. Our result also showed that low BCL2 expression level is associated with
significant clinical characteristics of the patient such as tumor grade, stage and breast cancer
type.
Conclusion: Findings of our study showed that BCL2 has a role in breast cancer formation
and might be a novel biomarker for the diagnosis and treatment of breast cancer.

Background: Scurf pin inhalation is serious problem especially in muslim girls, who wear
head cover and holding the pin by using her teeth or lips during wearing her scurf or
laughing or coughing leading to accidental foreign body aspiration. Rigid Bronchoscopy is
the treatment of choice and rarely surgery is needed.
Objective:To study a presentation, management and prognosis of those patient.
Patients and Methods: A retrospective study involving the patients with a history of pin
aspiration conducted at the department of thoracic surgery , Imam Hussein medical city in
kerbala for Dec. 2012 till Dec. 2017.
Results: 262 patients are included. The pins were removed by using rigid bronchoscopy in 251
cases safely without any complications ,4patients were coughed the pin before enter the theatre
room&7patients were coughed and swallowed it in digestive tract.
Conclusion: Scurf pin aspiration is a common problem in Iraqi Muslim females who wear
Hijab. It can be easily preventable by health education and/or newly fashioned scarves that
do not need pins for fixation but use press studs or something else. The left main bronchus is
the site were the pin is commonly impacted and Rigid bronchoscope is mostly used for pin
removal.