Diyala Journal of Medicine

Background: Vertigo is a symptom that neurologists and otologists are confronted with.
Magnetic resonance image (MRI) is used for imaging.
Objective: To determine the diagnostic yield of MRI in patients with vertigo and to Identify
the most common causes.
Patients and Methods: This observational study involved 110 vertigo complaining patients
attending the MRI unit of Rizgary teaching hospital examined by 0.2 Tesla MRI between
June 2007 and September 2008.Collected variables divided into Group 1 (normal MRI) and
Group 2 (abnormal MRI) analysed and compared.
Results: Group 1= (70%) and Group 2=(30%), abnormal MRI findings in male patients was
(59.6%), in female (40.4%,) the commonest abnormalities were cerebellopontine angle (CPA)
space occupying lesions (SOL) (9.2%), cerebellar SOL (7.4%), 4th ventricle SOL (7.4%) and
deep white matter ischemia (7.4%), most of patients with vascular problems were more than 50
years. In (35.4%) of patients, vertigo was less than one month duration, (50%) of which had
abnormal MRI findings. Out of seven patients with normal MRI, 5 patients showed vascular
lesion on magnetic resonance angiography (MRA).
Conclusion: MRI remains important diagnostic tool for evaluation of vertigo and MRA is
necessary when vascular origin is suspected.

Background: Thyroid diseases may disturb liver function; liver disease modulates thyroid
hormone metabolism, and a range of systemic diseases disturb both organs. There are clinical
and laboratory relations between thyroid and liver diseases. Patients with chronic liver
disease may have thyroiditis, hyperthyroidism, or hypothyroidism.aPatients with subacute
thyroiditis or hyperthyroidism may have abnormalities in liver function tests, which return to
normal as the thyroid disorder improves.
Objective: The present study is designed to investigate the effects of thyroid disorders on
liver function tests.
Patients and Methods: In this study sixty patients were employed and categorized into two
groups, thirty patients with hyperthyroidism (13 male and 17female) with age range of 25-
45years, (mean 33.38) and thirty patients with hypothyroidism (11male and 19 female) with
age range 25-45 years (mean 36.78),while 30 normal healthy individuals were chosen as a
control group (15male and 15 female) in the same age range (mean 34.44) were taken for
comparison. Blood samples were collected from the patients at Baqubah Teaching Hospital
, between April 2020 to July 2020. Basic serum biochemical parameters including, thyroid
stimulation hormone (TSH), triiodothyronine(T3) and thyroxin (T4)were assayed for patients
and control groups by Cobas e 411 autoanalyzer within eight weeks. Serum normal values for
alanine aminotransferase (ALT). ALT (Alanine Aminotransferase), Aspartate
aminotransferase (AST), alkaline phosphatase test (ALP), direct bilirubin (DB) and total
bilirubin( TSB) were assayed within four days by Cobas integra 400 plus autoanalyzer.

Background: The prevalence of oral mucosal lesions in infants and neonates is still a matter
of debate.
Objective: To find the frequency of oral mucosal lesions in children from Sulaymaniyah
city.
Patients and Methods: A cross-sectional study was performed in Maternity and Pediatrics
Teaching Hospitals in Sulaymaniyah city. Twohundred children aged from birth to two years
old were randomly selected. Demographic features, mode of delivery, pattern of feeding, and
type and site of oral mucosal lesions, were recorded.
Results: Male: female ratio was 1.06:1, and 64% were delivered by cesarean section.
Significant differences were present between breastfeeding with the mode of delivery and age of
the infants. Oral mucosal lesions were observed in 64.5% of children at 141 sites. 30% of
lesions are located at median palatine raphe. The diagnosis of 30% of oral mucosal lesions was
Epstein pearls, and 16% were Bohn’s nodule. The oral mucosal lesions were more frequently
seen in children within the first week.
Conclusion: About three-quarters of children was afflicted with oral mucosal lesions.
Besides, Epstein pearls and Bohn’s nodule were among the most frequent diagnosis. Further,
ages of a week or less afflicted more with congenital oral mucosal lesions.

Background: The aim of the study was to know noise induces hearing loss and the effect of
the noise on peshmerga that participated in the Daesh war in Erbil city. One of the health
problems or most common forms of sensorineural is the noise induced-hearing loss.
depending on the exposure noise induce cause damaging of the cochlea. So, one of the causes
of noise induced hearing loss is exposure to the excessive noise.
Objective: To determine noise induce hearing loss among peshmerga participated in the
Daesh war in Erbil city.
Patients and Methods: In the present study, a total of (253) Peshmerga of four special
brigades who exposed to noise in the Daesh war in Erbil city was performed, also pure tone
audiogram was done for each peshmerga in the Auditory department at Hawler teaching
hospital. Also, pure tone audiogram and firearm noise levels for the right and left ear for each
degree of hearing loss for the range of the noise induced hearing loss (4000Hz) performed
and hearing loss range in dB. Slight/Mild from 16-40dB, Moderate/Moderate severe from 41-
70dB, and Severe/ Severe profound from 71-120 dB. were evaluated for each peshmerga in
the auditory department at Hawler teaching hospital to know the cause of inducing hearing
loss. Subjects answered a questionnaire and underwent threshold tonal audiometry.
Results: Two hundred and fifty-three peshmerga who participated in the Daesh war, was
enrolled in this study that subdivided into four age groups (20-29), (30-39), (40-49), (50-59)
years, pure tone audiogram was done for each peshmerga for right and left ear.
Conclusion: Because of the nature of the profession military, the common disease in the
military is induce hearing loss is caused by noise. Hearing is the vital origin during exposure
to loud noise. So, prevention is needed and to be a learner with care to the use of hearing
protection devic

Background: Although High body mass index is associated with many cardiovascular
diseases including coronary artery disease. Its effect on in-hospital death in patients with
acute ST-segment elevation myocardial infarction (STEMI) is still a subject of controversy.
Objective: To determine the correlation between body mass index (BMI) and in-hospital
mortality in those patients.
Patients and Methods: In this cross-sectional study, 180 adult patients with acute STEMI
were enrolled and their BMI was measured. The participants were classified according to
BMI into three groups as normal, overweight, and obese. A correlation between in-hospital
mortality due to STEMI and BMI was evaluated.
Results: Of the total participants, 62 (34.4%) were normally weighted, 61(33.8%) were over-
weighted, and 57(31.6%) were obese. There was a significant difference (p= <0.001) between
the groups concerning troponin I, hs-CRP, GRACE score, and the probability of in-hospital
death. There were 16 (8.8%) in-hospital deaths during the study distributed as follows; 1(1.6%)
in the normal-weight group, 5(8.1%) in the overweight group, and 10 (17.5%) in the obese
group. In-hospital death showed a significant difference (p=0.04) between the study groups. In
addition, a significant positive correlation(r=0.9) was found between BMI and in-hospital death.
Conclusion: A robust positive correlation was detected between BMI and in-hospital
mortality due to acute STEMI. When BMI increases, the number of deaths also increases
exponentially.

Cherubism is an autosomal dominant, very rare benign fibro-osseous lesion, with an
estimation of only 300 cases have been reported worldwide. Cherubism is characterized
clinically by bilateral symmetrical self-limiting jaw enlargement starts in the childhood or
early teens.Mandible is mostly affected although maxilla and zygomatic bones may be
involved but to a lower extent), and is associated with tooth displacement and severe
malocclusion. Histopathologically, it is indistinguishable from giant cell lesions therefore the
clinical manifestations of the disease remain the Gold Stone.

Background: Polycystic ovarian syndrome is a common endocrine disorder of women
during reproductive age, associated with increased risk of cardiometabolic diseases.
Objective: To assess the prevalence of cardiovascular risk factors in patients with the
polycystic ovarian syndrome in comparison to age-matched control.
Patients and Methods: This cross-sectional studyis conducted in Erbil city fromSeptember
2020 to January 2021. It included 40 cases of polycystic ovarian syndrome and 40 cases of
healthy controls. Participants underwent detailed history, physical examination. Laboratory
investigations (blood sugar, lipid profile, serum testosterone and serum prolactin) and pelvic
ultrasound were done for them. Data analysis was performed by Statistical Package for
Social Sciences (SPSS) version 25.
Results: Women with the polycystic ovarian syndrome have a higher proportion to obesity,
abnormal blood sugar, and dyslipidemia, they have higher rate of menstrual irregularity,
hyperandrogenic state and hirsutism, than age-matched control. The risk for hypertension
remains the same for both PCOS and the control group.
Conclusion: The proportion of obesity, diabetes, and dyslipidemia is higher in Polycystic
ovarian syndrome than the control group.

Background: Oral and systemic infections are closely linked to poor oral hygiene.
Chlorhexidine mouthwash, in addition to tooth brushing has been commonly recommended.
About the fact that there is a lot of studies on the effectiveness of chamomile as an herbal
mouthwash, there isn't much evidence on its competitive effect with chlorhexidine.
Objective: To determine the clinical and inflammatory effects of chamomile as mouthwash
(MTC) in the treatment of chronic gingivitis and compare its effect with 0.12% chlorhexidine
(CHX).
Patients and Methods: A total of 45 subjects aged 18-45 years with chronic gingivitis
underwent scaling and polishing with oral hygiene instruction; 15 patients received 1% of
(MTC) as mouthwash, 15 patients received 0.12% of chlorhexidine mouthwash, and 15
patients received scaling and polishing only (SRP). Mouthwash was twice daily for 14 days.
At the start of the study, clinical periodontal parameters (PI, GI, and BOP) and blood
samples were taken and after four weeks of treatment to estimate the levels of C-reactive
protein (CRP), alkaline phosphatase (ALP) and total protein (TP).
Results: After 4 weeks of periodontal treatment, there was a significant decrease in clinical
periodontal parameters (P<0.01) and inflammatory markers (P<0.05) in the MTC and CHX and
S&P alone groups. From periodontal treatment, there was no significant difference between the
MTC and CHX groups with clinical periodontal parameters and inflammatory markers
(P<0.05), although there was a significant difference between the MTC, CHX groups, and the
S&P alone group in terms of clinical periodontal parameters and inflammatory markers
(P<0.05).
Conclusion: Chamomile has been shown to be comparable to CHX in terms of reducing
gingivitis by decreasing clinical periodontal parameters and inflammatory chemical markers
values such as CRP, ALP, and TP.

Background: Aloe Vera contains many inorganic electrolytes like iron, potassium,
chromium, copper, sodium, calcium, and zinc that are vital parts that induced the wound
healing process as a result of the ability to prevent injury to the epithelium and promote
healing of injured tissues. It improves healing by increasing the blood supply and oxygen to
the area of injury tissue.
Objective: To evaluate the anti-inflammatory effect of Aloe Vera on wound healing in rats
with full thickness flap and insertion of Aloe vera gel at the site of injury throughout analysis
of the activity level of serum interleukin-1beta (IL-1β).
Patients and Methods: Fifty five male rats were randomly divided into three groups: A-
Aloe vera gel (25 rats), subdivided into (5) subgroups as a test group, B- Chlorhexidine gel
(25 rats) was also subdivided randomly into (5) subgroups as a test group. Each subgroup
(5rats) was exposed to surgery and filled with (AV) and CHX gel in both. C-non-surgical
control group (5 rats) to obtain baseline data. A sulcular full thickness flap incision was
carried out between the two maxillary central incisors. Blood samples for immunological
studies were collected by cardiac puncture, at times (3, 5, 7, 10, and14 days) for estimation
of serum (IL-1β) levels using Indirect ELISA Technique in all groups.
Results: A highly significant decrease of serum IL-1β in rat group (A) within 3 and 5days post-
surgery, then the concentration of this cytokine started to increase on 7,10and 14days post-
surgery, which is statistically non significantly affect with the control group (C), where it
reaches the level of the control level before surgery.
Conclusion: Aloe vera shows anti-inflammatory effects by decreasing the inflammation of
periodontal tissue post-surgery which could accelerate healing based on a significant
increase in the level of serum (IL-1β), reaching the control level before surgery at 14days,
post-surgery that indicated positive results of this study.
2021 Diyala Journal of Medicine 75 DOI:https:/

Background: Pomegranate (PG) fruit (punicagranatum L, Punicaceae contains many
bioactive substances that play important role in the treatment of a variety of medical
problems. Among PG parts, it was observed that the peel had the most potent antioxidant
activity.
Objective: To evaluate some serum antioxidants levels in mandibular bone injury healing in
rabbits orally supplemented with pomegranate peel extract (PPE).
Patients and Methods: Forty-five male rabbits (1-1.2 kg) were used and they were divided
into 3 groups; the baseline group consisted of 5 rabbits without creating mandibular bone
defects. 20 rabbits were used as a study group with creating mandibular bone defects and
they received orally 1ml/day of PPE. Another 20 rabbits were used as a control group with
creating mandibular bone defects without receiving PPE. For each rabbit of both study and
control groups, a circular defect of 3 mm in diameter was made in the mid labial area of the
alveolar bone of the lower right central incisor. Blood samples were taken from the baseline
group and both the study and control groups at time intervals; 3hrs, 1, 3, and 7days after bone
defect creation, for estimation of serum albumin (Alb), bilirubin (Bili), zinc (Zn), and
magnesium (Mg) levels.
Results: Serum Bili levels significantly increased 1and 3 days after bone defect creation in both
study and control groups, while the levels returned back to baseline in a study group, 7 days
after the operation. Serum Alb, Zn, and Mg levels showed a significant decrease in study and