Diyala Journal of Medicine

Background: Pomegranate (Punica granatum) is an edible fruit that has been described as a
medical and therapeutic functional food in the Middle East and the Mediterranean.
Objective: To investigate the use of serum creatinine (Cr) level and creatine kinase (CK)
activity as indicators for gingival wound healing process rate in rabbits, supplemented on
pomegranate seed extract (PSE).
Patients and Methods: A total of 45 rabbit males were used. They were divided into 3
groups; 5 rabbits as a baseline group that left without a buccal gingival wound. 20 rabbits (5
rabbits per each time interval) as a study group with buccal gingival wound with PSE
supplementation, and another 20 rabbits (5 rabbits per each time interval) as a control group
with gingival wound without PSE supplementation. A buccal gingival wound was created on
the lower right central incisor, and the suture was removed after (7) days. Blood samples
were collected for the baseline group and at time intervals; 3 hour, 1, 3, 7 days after creating
the wound for both control and study groups to determine serum Cr and serum CK.
Results: Serum Cr and CK significantly increased in all time intervals after gingival wounds, in
the control group compared with baseline values. Whereas the levels significantly increased in
rabbits receiving PSE at intervals of 3 hours, 1 and 3 days after gingival wound, they returned to
the baseline values, seven days after gingival wound incision.
Conclusion: Serum Cr and CK increase in the buccal gingival wound, while oral
supplementation of PSE can decline them to the baseline value after a period of time,
therefore these parameters can be used as indicators for gingival wound healing rate.

Background: The hypertensive pregnancies complicated by preeclampsia show an increase
in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been
employed for fetal surveillance.
Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy
outcomes in hypertensive pregnant women at the third trimester of pregnancy.
Patients and Methods: A clinical prospective follow up study conducted in Outpatient
Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018
till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at
the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal
death occurs during follow-up of pregnant women or more than two of the reported neonatal
complications were poor.
Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility
indices ratio were significantly decreased among pregnant women with poor neonatal outcomes.
Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were
Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with
hypertensive disorders are good predictors for neonatal outcomes.

Background: Seizures are defined as a transient occurrence of signs and symptoms due to
the abnormal, excessive, or synchronous neuronal activity in the brain characterized by
abrupt and involuntary skeletal muscle activity. Seizure is related to specific risk factors like
positive family history, fever, infections, neurological comorbidity, premature birth, mother’s
alcohol abuse, and smoking in pregnancy. Epilepsy is the most frequent chronic neurologic
condition in children. Studies have suggested declining incidence rates of childhood epilepsy
in high-income countries during the last decades.
Objective: To describe the clinical features and social findings of epilepsy in children, and to
evaluate some risk factors associated with control of epilepsy.
Patients and Methods: This cross-sectional study was conducted in the pediatric department
of Albatool teaching hospital in Diyala province, Iraq. A total of 100 children were included
in the study from February 2020 to May 2020. All children diagnosed with epilepsy in this
study.
Results: One hundred children with epilepsy, their mean age was 5.96± 3.33 years (range 1-14
years). Of the 48(48%) children were male and 52(52%). Of the total patients, 79% were free
from seizure on AED, 21% of them were refractory to treatment.Patients without
developmental delay (88.7%, p=0.012) can be controlled by AED. Patients who had
idiopathic seizures (87.5%, p=0.04) can be controlled by AED. Patients who had seizure
attacks can be controlled by AED more than patients who had weekly or monthly seizure
attacks (97.4%) (p<0.001). Patients who had been treated by monotherapy (94.7%, p=0.012)
can be controlled more than patients who were treated by multidrug therapy. Affected social
interaction and need more supervision were factors that detected more in patients with

Background: Multiple sclerosis (MS) is an inflammatory disease of the central nervous
system, in which the myelin sheaths got injured. The prevalence of MS is on grow, as well
as, it affects the young ages. Females are most common to have MS compared to males.
Oxidative stress is the situation of imbalance between oxidants (free radicals and reactive
oxygen species (ROS)) and antioxidants in a living system, in which either the oxidants are
elevated or antioxidants are reduced, or sometimes both. ROS and oxidative stress have been
implicated in the progression of many degenerative diseases, which is important in cracking
the unrevealed mysteries of MS. In this review article, some of the proposed mechanisms that
link oxidative stress with MS disease would be described

Background: COVID-19 infection started in China and became a pandemic, the SARS-
CoV-2 virus mainly affects the respiratory system but can insult the cardiovascular system
as well, higher rate of cardiac arrhythmias noted during the pandemic, and many studies
showed that COVID-19 (especially hospitalized patients) can develop different types of
arrhythmias which cause higher mortality rate.
Objective: To assess the incidence of dysrhythmias and their types and outcomes in
hospitalized patients with COVID-19 in Erbil city.
Patients and Methods: Patients with documented COVID-19 infection admitted in Erbil
Teaching Hospital respiratory care unit and coronary care unit from 1-8-2020 to 30-10-2020
had been included (255 patients) in this cross-sectional study, demographic data, and
outcomes were reported, the ECG analyzed by cardiologists and the type of arrhythmia
documented.
Results: Mean age was 47±12 years, 61% of the patients were male, 25% of them had previous
cardiac diseases, 20% diabetes, 16% multiple comorbidities, 8% hypertension, 8% obesity and
23% had no comorbidities, 20.7% of in-hospital patients developed dysrhythmias, 5.9% of them
developed sinus tachycardia, 4.7% atrial fibrillation, 3.9% ventricular premature contractions,
2% ventricular fibrillation, 1.9% ventricular tachycardia and 1.9% heart blocks. Most of the
patients who developed ventricular arrhythmias, atrial fibrillation, and heart block had previous
comorbidities 82%, 62%, and 80% respectively. Arrhythmias caused a higher in-hospital
mortality rate (39.6% versus 21.7%) especially among male patients (mortality rate in male
patients 43% compared with female patients 33%).
Conclusion: Most of the admitted cases were male. Most of them had comorbidities
especially previous cardiac diseases. Sinus tachycardia, atrial fibrillation, and ventricular
extra-systoles were the most frequent arrhythmias. The mortality rate was increased by
arrhythmias mainly in male patients.

Background: Colon cancer is the third most common cancer. High (BMI) contributes
hazardously for several types of malignancies including colon cancer while the effect of BMI
as a prognostic factor is poorly defined.
Objective: Demonstrating the influence of increasing (BMI) on colon cancer recurrence.
Patients and Methods: Case-control study involved a sample of 312 patients and 131
patients were excluded from this study and only 181 patients of colon cancer are included in
the study with stage 2 and 3 who did underwent a surgical operation and received adjuvant
chemotherapy recruited from an oncology teaching hospital, Al Jawad oncology center
(Alkadhemiya hospital) and Babylon Oncology center.
Results: The study involved 181 patients of colon cancer patients with mean age of 56.25
±11.74years the highest proportion of study patients (90.6%) were aged more than 40yrs with a
male to female ratio (1.2:1). Overweight patients constituted 39.2% and obese 23.8% and
normal body weight 37%. In this study majority of tumors are ulcerating for about 72.5% and
sigmoid and left side colon was the most common site of the tumor in about 53% with stage
three is a most common type. Regarding recurrence, 54.1% of study patients have recurrence,
and the majority of the 41.8% occurs between 1-3years after primary tumors diagnoses and
treatment with a high prevalence of recurrence was seen in obese patients (74.4%) with a
significant association between prevalence of recurrence and increasing BMI. In this study,
61.2% of patients with lymphovascular invasion have recurrences of malignancy with
significant associations between recurrences and LVIe. Also more than 50% of patient older
than 40years got recurrences with significant associations between recurrences with age of
patients. In this study we take the effect of each clinicopathological feature on the outcome of

Background: Hydatidosis is a zoonotic disease caused by Echinococcus granulosus and
Echinococcus multilocularis parasite which is still endemic in many countries all over the
world especially in the developing countries. The liver is the primary site to be infested by
the parasite with a rate of 60 – 75%. The right lobe of the liver gets infected in about 80% of
cases. Hydatid disease of the liver is usually asymptomatic and most cases discovered
accidentally on routine clinical or radiological examinations for other illness. Symptoms
usually appear in complicated cases either due to rupture, secondary bacterial infection, or
due to the large size of the cyst which might cause pain in the right upper quadrant of the
abdomen, discomfort, and sometimes swelling. In this case report, we reported the presence
of fat globules within the hepatic hydatid cysts which is most probably due to rupture of
hepatic hydatid cysts into the biliary tree.

Background: Chickenpox is a viral disease caused by a virus called Varicella Zoster Virus
(VZV). It is more prevalent among children less than 10 years.
Objective: To estimate the prevalence of chickenpox among the different age groups and
monthly distribution per year in Baquba city sectors recorded in Baquba teaching hospital.
Patients and Methods: Data was collected of 82 patients from 1st January –31 th July 2019,
and the statistical data was recorded as name, age, sectored where patients' lives.
Results: Eighty-two patients with chickenpox data were collected in Baquba teaching hospital,
male 52(63.4%) , and female 30(36.5%) of cases in different age groups, were highest
prevalence in(9-12) years age group (30) cases, and lowest in cases older than 12 years old were
(6) cases reported, t-test (2.671).
Conclusion: Chickenpox more common in male, highest infections were reported in winter
months.

Background: Colonic masses are clinically important because some of them are malignant
and others have a tendency to become malignant such as polyps. CT pneumocolon may have
a role in the evaluation and diagnosis of these masses.
Objective: To determine the accuracy of computed tomography (CT) pmeumocolon in the
detection of colonic masses compared with colonoscopy.
Patients and Methods: A total of 60 patients with colorectal symptoms underwent
evaluation for the presence of colorectal neoplasms by using both colonoscopy and CT
pneumocolon and a comparison was made between them.
Results: On colonoscopy, 10 out of 60 patients were having a negative colonoscopy. The
results of colonoscopy of the other 50 patients were as follow; three out of fifty
colonoscopies revealed invasive colorectal carcinomas in threse patients. The remaining 47
colonoscopies for 47 patients revealed benign polyps. The sizes of these polyps were as
follows; (6 polyps were ˃1 cm in diameter), (17 polyps were 6-9 mm), and (24 polyps were
≤5 mm). CT pneumocolon detected all 3 malignant masses seen and biopsied by
colonoscopy, but only (28 single polyps) which according to their size (4 polyps were ≥
1cm), (11 polyps were 6-9 mm) and (13 polyps ≤5 mm), this gives CT pneumocolon a
sensitivity of (63%), specificity of (70%) and accuracy (63%).
Conclusion: CT pneumocolon has high sensitivity and specificity for a detection of large-
sized masses, but not for small ones. CT pneumocolon may be suitable for investigating
patients with symptomatic colorectal masses noninvasively.

Background:Rheumatoid arthritis is a chronic systemic inflammatory disorder that is
associated with progressive disability and systemic complications. One of these
complications is osteoporosis. Patients with severe osteoporosis have one or more fragility
fractures in addition to T-score -2.5 or lower. Osteoporosis is more prevalent in rheumatoid
arthritis patients who have higher disease activity.
Objective: To show the effect of irregular treatment in patients with rheumatoid arthritis on
the severity of osteoporosis.
Patients and Methods: A cross-sectional study enrolled a total of 40 female patients who
had rheumatoid arthritis. The data collected from patients include disease duration, disease
activity and patients’ compliance to their drugs. They were sent to dual-energy x- ray
absorptiometry scan and results were recorded.
Results: The mean age was 45.95 ± 10.0 years; 45% of them had rheumatoid arthritis for less
than five years; 55% had a low level of disease activity; and 65% of them had received
treatment irregularly. Osteoporosis was diagnosed in 60% of them and 41.7% of them had
severe osteoporosis. The highest prevalence of osteoporosis among patients with rheumatoid
arthritis was seen significantly among older patients, patients with longer duration of
rheumatoid arthritis, those with higher activity of rheumatoid arthritis, and those with irregular
treatment. More than half of those who received treatment irregularly had severe osteoporosis
with a significant association between treatment regularity of rheumatoid arthritis and severity
of osteoporosis.
Conclusion: Severe osteoporosis occurs in rheumatoid arthritis patients with a history of
irregular treatment which occurs either due to patient incompliance or delay in diagnosis.