IRAQI JOURNAL OF MEDICAL SCIENCES

Background: Alterations of p53 gene are the most common mutations in human cancers. In bladder cancer, p53 mutations have been associated with high tumor grades and advanced stages, as well as progression of superficial disease to muscle invasive disease. Moreover, p53 nuclear over expression appears to be an independent predictor of disease progression and decreased survival after cystectomy.
Objective: The objective of the study is to evaluate the P53 expression percentage in patients with transitional cell carcinoma of the bladder and the relation of this expression to superficial cancer, muscle invasive disease, and carcinoma in situ as far as the tumor grade, clinical stage and response to intravesical mitomycin chemotherapy is concerned.
The expression of P53 in normal bladder mucosa, taken from patients admitted for ureteral endoscopic procedures, was used as a control group
Method: The expression of p53 protein was studied by immunohistochemical analysis in paraffin embedded specimens from 58 patients with transitional cell carcinoma of the bladder and 20 patients with normal urinary bladder (control group), these patients were admitted for insertion or removal of double J ureteric stents. Patients with superficial tumors (stage T1, Ta) were treated with intravesical chemotherapy with mitomycin C (20-40mg). once weekly for 6 weeks and cystoscopy repeated after 3 months , 6 months and 9 months. Patients with superficial muscle invasive disease were subjected to extended transurethral resection followed by intravesical chemotherapy and cystoscopy repeated at 6 weeks, 3 months and 6 months. No treatment other than MMC was given.
Results: P53 over expression was observed in 29 (50%) out of 58 patients with transitional cell carcinoma of the bladder, with no case of p53 over expression observed in the control group.
A statistically significant relation was noticed between p53 over expression and clinical stage, with p53 over expression was more common in muscle invasive tumors. P53 over expression was also more common in high grade tumors; however, no statistically significant relation between p53 expression and tumor grades and response to intravesical chemotherapy with mitomycin C was noticed.
Conclusions: P53 over expression was noticed in half of the patients with transitional cell carcinomas of the bladder, it was much more common in muscle invasive tumors and more frequent in high grade tumors, however, it seems that p53 status did not predict response to intravesical mitomycin C chemotherapy.

Back ground: The failure of current treatment strategies to control many cases of IBD makes a strong stimulus to find out new modalities of treatment.
Objective: to study the effects of oral curcumin, and black cumin on induced colitis in rabbits.
Materials and Methods: Colitis was induced in rabbits by rectal acetic acid-ethanol (model 1), or acetic acid (model 2). The effects of tested agents (curcumin, and black cumin) were compared to distilled water (control), and prednisolone regarding changes in body weight, colon segment weight, and gross and microscopical scores.
Result: In model 1, severe gross and microscopical damage observed in colon. Gross and microscopical scores of curcumin group were not significantly different from that of control and of prednisolone groups.
In model 2, a less severe inflammation occurred; yet, an evident gross and microscopical damage were observed.
Black cumin and prednisolone treatment reduced the loss of body weight of rabbits in comparison to the control. The gross and microscopical damages were apparently lowered when black cumin, curcumin and prednisolone were used, but these changes were significant for prednisolone, and black cumin (grossly), and for prednisolone (microscopically).
The gross and microscopical effects of curcumin, and black cumin were comparable to those of prednisolone.
Conclusion: Acetic acid-induced colitis in rabbits (model I) is preferred for testing the anti-inflammatory effectiveness of new therapeutic modalities.
Black cumin oil and curcumin have an anti-inflammatory activity in this model.

Background: clinical epidemiological studies have shown that human papillomaviruses play major role in the development of different types of cervical lesions, are therefore considered as the major infectious etiological agents of genital lesions and cancer.
Objective: to determine the prevalence of HPV DNA by using in situ hybridization technique among archival tissue specimen of the uterine cervical lesions and normal cervical postmortem tissue biopsies.
Material & Methods: Eighty cervical tissue samples were included in this study. 70 archival tissue biopsy samples comprised a risk group for HPV infection and / or cervical neoplasia; these were selected for the years from 1998 to 2005 from histopathology files of Al-kadhimiya teaching hospital, Al-Ilwiya teaching hospital, Al-Yarmouk hospital, Medical city department of teaching laboratories, and from four private laboratories. The patients mean age was 43.1 years with a range of 20 to85 years. The remaining 10 normal cervical postmortem tissue
biopsies were obtained from the institute of forensic medicine and considered as control group. These autopsies were taken from virgin female cervices, their mean age 23.1 years with a range of 18-30 years. In Situ Hybridization was performed for the detection of HPV on cervical tissue.
Results: All normal control cases showed no specific signals for HPV DNA. 6 (30%) of 20 cases of cervical tissue with codylomatous changes, 1 (11.11%) of 9 cases of CIN I.3 (21.43%) of 14 cases of CIN II/III, and 9 (33.33%) of 27 cases of ISCC were shown to be positive for HPV 6/11/16/18/31/33 DNA.
Conclusion: The In situ hybridization enabling direct visualization of viral tissue distribution and better substantiate HPV as a causal agent in cervical neoplasia.A significant association (p <0.05) was found between Insitu Hybridization signal pattern and the histological type of cervical noeplasia.

Background: It was estimated that several million people are frequent users of khat, living in countries between South East Africa and Arabian Peninsula.
Khat (Catha Edulis Forsk) is described as an evergreen shrub of the species plant family celastraceae.
Chewing of khat leaves and ingesting the juices that contain the psychoactive substance, Cathinone, produces sympathomimetic and CNS stimulation.
It has deleterious effects on the rate of spermatogenesis, decreasing the sperm count; percentage of sperm motility and increase the number of abnormal sperm forms.
Objective: To prove that chewing khat affects the human spermatogenesis and sexual behavior; and to emphasize the cathinone effect on the human spermatogenesis and to explore the sexual behavioral changes due to khat use.
Materials and methods: A fifty healthy Yemeni khat chewers aged between 20 to 50 years were randomly selected. A questionnaire survey method was used to investigate their sexual behavior and a routine semen analysis was done.
Result: The study showed that 94% of the khat chewers have sperm counts below the normal range while 6% above the normal range; about 72% of the khat chewers have less than 60% active motile sperms and abnormal sperm forms while 28% of the khat chewers have more than 60% active motile sperm and abnormal sperm forms.
A correlation was found between the period of khat consumption and an initial decrease in sperm count and the percentage of active motile sperm with subsequent increase in the numbers of abnormal sperms.
A strong association was found in chewer’s using high quality of khat and a decrease in sperm counts and the percentage of active motile sperms with increase the numbers of abnormal sperms when compared with low quality of khat.
Conclusion: In Yemen, the habit of chewing khat affects human spermatogenesis. Khat chewing affects elderly people more than younger ones and the high quality of khat affects spermatogenesis more than low quality of khat variety due to its higher content of cathinone.

Background: Apoptosis is a physiological type of cell death characterized by certain morphological nuclear and biochemical changes. This process deletes the unwanted cells by a clean mechanism that does not evoke any inflammating changes.
Objective: To show the effect of laser light on the lymphocyte apoptosis.
Subject & Methods: The study was conducted on lymphocyte apoptosis. The taken number of apoptotic lymphocyte was estimated before and after exposure.
Results: Results showed that there was a significant increase in the percentage of lymphocyte apoptosis after exposure to 630nm laser light, which was further increased by increasing the time of exposure.
Conclusion: Lymphocyte apoptosis can be induced by low dose of laser and increasing the exposure time can increase this.

Background: Many research works clearly indicate that free radical and reactive oxygen species play a major role in the etiology and development of breast cancer in postmenopausal women. Available literatures suggest that tamoxifen is a potent suppressor of lipid peroxidation in experimental animals.
Objectives: The objective of this study is to understand the antioxidant status and oxidative stress in breast malignancy of postmenopausal women before and after treatment with tamoxifen.
Methods: Eight to nine months’ tamoxifen therapy (10 mg twice daily) in 19 postmenopausal women was conducted. Serum levels of vitamin A, E & C were determined; also uric acid& GGT were determined. The results were correlated with serum MDA levels. The results were compared with those in patients with breast benign tumors (N=21) and control group (N=23).
Results: A highly significant decrease in antioxidant vitamins levels in breast cancer patients were noticed (P<0.001) compared with those of benign tumor. Also a significant increase in uric acid, GGT, and MDA levels was observed in cancer patients (P<0.01). There was a significant increase in antioxidant vitamins (P<0.01) and significant decrease in uric acid, GGT and MDA levels in cancer patients after treatment with tamoxifen.
Conclusion: The results suggest that tamoxifen exerts a significant effect on the rate of lipid peroxidation and a major improvement in antioxidant status

Objective: The current study aimed to detect some changes occurred on the surface of T lymphocytes manifested by CD3, CD4 and CD8 molecules that may have a role in patients with idiopathic preterm labour.
Setting: Al-Kadhimyia Teaching Hospital / Department of Obstetrics & Gynecology for a period of one year (March 2002-March 2003).
Study design: Thirty patients with idiopathic preterm labour were enrolled in this study in addition to thirty healthy pregnant women as a control group. Blood samples were taken from both groups, lymphocytes were separated and immunofluorescent labeled by monoclonal antibodies to CD3, CD4 and CD8 surface markers.
Results: Patients have a significant low percentage of these surface markers in comparison with control subject.
Conclusion: The above findings confirm the suppression of cellular immunity in patients with idiopathic preterm labour.

Background: Genomic studies have confirmed that the main locus defining the genetic susceptibility to T1DM is encoded within the Major Histocompatibility Complex- HLA (Human Leukocyte Antigen) region on human chromosome 6.
Objective: To investigate the role of HLA-class I and class II antigens in the etiology of type 1 diabetes mellitus (T1DM) and in prediction of this disease in siblings.
Patients & methods: Sixty T1DM children who were newly onset of the disease (diagnosed less than five months) were selected. Their age ranged from 3-17 years. Another 50 healthy siblings were available for investigation of HLA-typing, their ages range from 3-16 years. Eighty apparently healthy control subjects, matched for age (4-17) years, sex and ethnic backgrounds (Iraqi Arabs), underwent the HLA-typing. Serological typing of HLA antigens was done by microlymphocytotoxicity assay.
Results & recommendations: At HLA-class I region, T1DM patients showed a significant increased frequency of antigens A9 (40.0 vs. 18.75%) and B8 (28.33 vs. 8.75%) as compared to control subjects, while at HLA-class II region, DR3 and DR4 were significantly increased in patients (53.33 vs. 26.25% and 50.0 vs. 12.5% respectively) as compared to controls. In addition to that, T1DM was significantly associated with DQ2 (33.33 vs. 15%) and DQ3 (40.0 vs. 20%) antigens as compared to controls, suggesting that these antigens had a role in disease susceptibility, while the frequency of DR2 and DQ1 antigens were significantly lowered in patients compared to controls (6.66 vs. 25% and 6.66 vs. 22.5% respectively). These molecules might have protective effect. In siblings a significant increase frequency of DR4 antigen (34.0 vs. 12.5%) was observed in comparison to controls, suggesting that it might be much useful for predicting T1DM in affected families. It is potentially valuable to predict TIDM in siblings by screening for HLA risky alleles in correlation with autoantibodies

Background: The pineal neurohormone namely melatonin regulates the bodily endocrine glands including thyroid gland, by controlling the function of pituitary gland.
Objective: To study the effects of different doses of dietary melatonin (as antioxidant) on male rat's thyroid, "histologically".
Methods: Melatonin was supplied to adult Wister albino rats, for successive 14 days. Rats were divided into 6 groups. Group I was the control. Group II, III, IV, V and VI were given a daily dose of 125, 250, 500, 750 and 1000 µg / kg body weight, respectively. After last day of treatment, animals were killed under effect of anesthesia and thyroid gland was taken for histological study.
Results: The results showed no significant effects on thyroid with the regarded as normal therapeutic dosages, whereas significant damaging effects were seen with the higher doses.
Conclusion: Dietary melatonin has no bad effect on adult rat's thyroid within therapeutic doses, but it had highly damaging changes in large doses.

Background: The prostate is the largest of the accessory glands of the male reproductive tract. Its secretion serves as a diluent and vehicle for transport of sperms from male to female, so its function is very important for the normal fertility. Melatonin is the basic neuro-hormone of the pineal gland, regulates the sexual and reproductive activities in all mammals including man.
Objective: This work aimed to study the effect of different doses of dietary melatonin on adult rat's prostate, "histologically".
Methods: Melatonin was supplied to adult Wister albino rats, for successive 30 days. Rats were divided into 6 groups. Group I was the control. Group II, III, IV, V and VI were given (mixed with their diet) a daily dose of 125, 250, 500, 750 and 1000 µg / kg body weight, respectively. The dietary melatonin was supplied to rats mixed with their food. After the last day of treatment, animals were killed under effect of anesthesia; prostate was removed for histological study.
Results: The results showed significant beneficial effects on prostate by normal therapeutic dosages, whereas significant damaging effects were seen with further stepping up doses.
Conclusion: Dietary melatonin has good effects on the rat's prostate within therapeutic doses, whereas it had highly damaging changes in overabundance.

Background: There are several regulatory proteins involved in the control of lymphocyte apoptosis. Their impairment may play a role in the pathogenesis of several autoimmune diseases. Recent studies have reported impairment in the apoptosis of peripheral blood lymphocytes (PBLs) in patients with rheumatoid arthritis (RA).
Objective: The aim of this study is to evaluate the cellular expression of P53 and BcI-2 proteins in the PBLs and their roles in the apoptotic process, and correlate their cellular expressions with the percent of peripheral T cell population.
Methods: This study involved forty-six RA patients were examined and compared with 17 healthy control individuals of similar ages. Lymphocytes were separated from peripheral blood samples, the assessment of their cellular expression of CD3 and regulatory proteins p53 and Bcl-2 by immunocytochemistry staining method.
Results: The results showed abundant accumulation of CD3 T lymphocytes in the peripheral circulation of RA patients in comparison with controls. A highly significant increased percentage of Bcl-2 protein expression in RA PBLs, compared to healthy control (p<0.001) while there was no such statistical difference regarding P53 expression in PBLs from both groups (p=0.278). The results of linear regression showed a significant correlation between the increased peripheral blood T lymphocytes and cellular percentage of Bcl-2 protein expression (p<0.001), while there was no such correlation with the percentage of P53 expression (p=0.587).
Conclusion: in conclusion of these results, we found an increase in the peripheral blood T lymphocytes from patients with RA that could be resulted from the noticed up-regulation of cellular expression of Bcl-2 protein, rather than with changes in cellular expression of P53 protein.

Introduction: Identification of stroke risk factors is of great importance to prevent the disease and its sequels.
Objective: Is to analyze the known stroke risk factors and to study the education level, housing condition and economic status as possible relevant stroke risk factors.
Patients and methods: 510 patients with ischemic stroke of different types and severity who were admitted to 3 hospitals in Baghdad. The patients were examined and investigated thoroughly. Special emphasis was concentrated on education level, housing condition and economic status.
Results: 510 patients were studied, 215 females and 295 males. The study showed 16 % higher male prevalence. Hypertension is commonest risk factor in the present study (75.5%) followed by other risk factors. the study showed a higher number of stroke patients [44.7%] was illiterate, in comparison to [9%] of the patients with the higher education. The study showed more prevalence of the stroke patients [90.39% live in crowded small houses. The study showed [36%] of stroke patients belongs to families with below 100 USD monthly incomes.
Discussion: Higher prevalence of diabetes mellitus, hypertension, smoking and also poor health awareness in patients with low educational levels, poor economic state and poor housing condition.
Conclusion: Stroke is increased in low educational levels, poor economic state and poor housing condition. There is a high percentage of hypertension not previously diagnosed despite stigmata of chronic hypertension.

Background: The etiology and pathogenesis of ulcerative colitis has not yet been elucidated. However, attention has been brought to the belief that a genetic factor plays a crucial role in the development of the disease.
Objectives: This study was established to shed light on the possible association of HLA class I and class II antigen with ulcerative colitis.
Methods: The study included 105 subjects. It comprised of 35 ulcerative colitis patients and 70 apparently healthy controls. Lymphocytotoxicity assay has been used to assess HLA-typing.
Results: Comparison between ulcerative colitis patients and healthy control showed positive significant associations of HLA –B14, B27 and DR52 antigens with patients, however, only B27 maintained a significant P value after adjustment. Meanwhile the frequencies of HLA -B35, B41 and Cw6 were decreased in patients when compared with control group.
Conclusions: These findings demonstrated that HLA –B14, B27 and DR52 might play a role in ulcerative colitis susceptibility, while HLA-B35, B41 and Cw6 may confer protective effects against ulcerative colitis.

Background: Premature delivery remains the most important cause of neonatal mortality and there is considerable amount of information in the literature indicating a strong association between maternal placental vasculopathy and chorioamnionitis with preterm delivery.
Objective: To outline the association between maternal placental vasculopathy and chorioamnionitis with preterm labor and premature rupture of membranes.
Patients & Methods: We performed a case control study conducted on 54 patients who were delivered preterm 37 patients because of preterm labor and 17 because of premature rupture of membranes, and 54 patients who were delivered at term after uncomplicated pregnancy for the period from January 2004 to July 2005. We studied the clinical information’s obtained include demographic data, gestational age, obstetric history, route of delivery, infants birth weight and placental histopathological features. All the patients were seen at Gynecology & Obstetrics department at Al-Kadhimiya Teaching Hospital in Baghdad.
Results: Maternal placental vascular lesions were present in 13 (35.1%) patients with preterm labor, and six (35.3%) patients, with premature rupture of membranes while only 6 (11.1) of control patients. Histopathological features suggestive of Infection of the placenta were found in 14 (37.8%) patients with preterm delivery and 6 (35.3%) patients with premature rupture of membranes and eight (14.8%) of control patients.
Conclusion: It is possible to identify two subgroups of patients among those who are delivered preterm because of preterm labor or premature rupture of membrane, one with infection of the product of conception and another with maternal placental vasculopathy.

Background: Th1-type cytokines secretion such as IFN-γ, and Th2 cytokines such as IL-10, have been shown to exert deleterious effects on pregnancy, inhibiting fetal growth and development .
Aim: Measurement of the locally concentrations of selected Th1 and Th2 cytokines in women with a history of recurrent spontaneous abortion (RSA) at the time of abortion using in situ hyberdization technique.
Methods: A total of one hundred and nineteen women, ranged from the mean age (23.9 − 28.5)years, were enrolled in the current study and were further classified into three categories: Group A- Recurrent spontaneous abortion (RSA): n= 62 women, with a mean age of (28.5 + 0.68);Group B- non- recurrent spontaneous abortion (non-RSA): n= 34 women, with a mean age of (26.4 ± 0.85)and group C- Control (successful pregnancy): n= 23 women, with a mean age of (23.9 ± 0.88). From each patient and control, placental tissues were collected. Trophoblasts tissues (an image for the local microenvironment) were screened to determine their in situ levels of IL-10 and IFN-γ based on cDNA probes (for in-situ hybridization, ISH).
Results: There was a significant increase in the level of IL-10 within trophoblast tissues biopsies exclusively from women with successful pregnancies (group C) (p < 0.001). On the other hand, IFN-γ was found predominantly expressed in trophoblast tissue biopsies of patients with RSA whether IHC or ISH were conducted (p< 0.05). Accordingly, only trophoblast tissues biopsies from patients with RSA revealed a significant increase in the ratio of IFN-γ/IL-10 levels expressed as determined by in situ hybridization in comparison to the same ration calculated from trophoblasts tissues of women with successful pregnancies (group C) (p< 0.001). as marker for Th2 immune response, during successful pregnancies. Furthermore, the current study failed to demonstrate a significant difference in the tissue levels of IL-8 between RSA and control group (p> 0.05) and no significant different between non-RSA and control (p>0.05) , (always p < 0.05).
Conclusion: These outcomes may further support the possible exisance of an immune response that orchestrates abortive phenomena and the possible protective role of IL-10.

Background: Plantar fasciitis is the most common cause of heel pain but treatment remains empirical.
Objective: To investigate the effect of interferon alpha 2b on pain, morning stiffness and tenderness of heels in patient with plantar fasciitis.
Methods: Three hundred seventy six patients with plantar fasciitis enrolled in this study. The patients divided into two groups: Group one received interferon alpha 2b 3MIUevery 3 days and group two treated with diclofenac. 50 mg two times daily with heel pads. The study conducted for 12 week.
Results: 92% of group one patients who received interferon alpha 2b became completely asymptomatic at week 6. At week 12 96.8% became completely free of symptoms.
Conclusion: Treatment with interferon alpha 2b in patients who had plantar fasciitis seems to be effective bringing complete cure.