IRAQI JOURNAL OF MEDICAL SCIENCES

Crimean-Congo Hemorrhagic Fever (CCHF) is the highest widespread, tick-borne viral hemorrhagic fever that affect humans. This virus is endemic in many areas in the world, such as Africa, Asia, and Europe. Nowadays, the incidence of CCHF is increasing rapidly in several countries of the middle-east, with several outbreaks and sporadic cases in human of CCHF, that are reported in several countries in this region.
Keywords: CCHF, Middle east, Iraq
Citation: Al-Obaidi AB. Crimean-Congo hemorrhagic fever in the middle east: history and facts. Iraqi JMS. 2018; 16(2): 111-113. doi: 10.22578/IJMS.16.2.1

Background: The sweet cherry (Prunus avium L) has a wide variety of secondary metabolites, which has biochemical and biological activity and used as potential source of a drug. There is no data published on stick cherry extract effect on enzymes activities, kidney function test, inflammatory marker and minerals. As well as on antimicrobial activity of stick cherry extract for inhibition the growth of pathogenic bacteria of different types.
Objective: To illustrate the effect of ethanolic stick sweet cherry extract on serum enzyme activities; lactate dehydrogenase (LDH), aspartate transaminase (AST), creatine kinase (CK) and the concentration of urea, uric acid, creatinine, C-reactive protein (CRP) also potassium, calcium in serum of albino mice as well as to investigate antimicrobial activity of the extract to inhibit the growth of different types of pathogenic bacteria.
Methods: A total of 28 albino mice were classified into three groups, the first control group (G1) consist of 8 animals treated with 0.2 ml/day distilled water, second group (G2) comprised of 10 animals treated with 30 mg/Kg/day of stick cherry extract, third group (G3) formed of 10 animals treated with 100 mg/Kg/day of extract.
Results: There was statistically significant reducing effect in serum enzyme activities of LDH, CK (P˂0.001) at 30 and 100 mg/Kg/day, and significant change in serum AST at low and high concentration. There is remarkable change in concentration of urea, uric acid, creatinine and increase in potassium and calcium (P˂0.001). The result of antimicrobial activity of stick sweet cherry extracts show inhibition the growth of pathogenic bacteria, different types which involves; (Pseudomonas aeruginosa, Escherishia coli, Staphylococcus aureus, Proteus vulgarweris, Serratiam arcescens). This indicates that the chloroform extract was active against the most pathogenic bacteria at all the concentration used and was more than ethanol extracts.
Conclusion: Orally administration of sweet stick cherries extracts to albino mice animals caused a potential difference in different biochemical parameters, enzyme activities, LDH, AST, CK, concentration of urea, uric acid and creatinine, C-reactive protein. Those are risk factors for different diseases, inflammatory, oxidative stress, heart disease. This could be minimized or prevented by polyphenols of cherries stick extract.
Keywords: Prunus, Creatine kinase, Sweet cherry, CRP, Potassium, Escherichia coli
Citation: Saleem MNMN. Effect of Stick Sweet Cherry Extracts (Prunus (SP)) on some biochemical markers in Albino Mice and Biological Activities in Different Types of Bacteria. Iraqi JMS. 2018; 16(2): 114-124. doi: 10.22578/IJMS.16.2.2

Background: The subtrochanteric fractures represent 7-44% of the fractures of proximal femur caused by low energy trauma in elderly patients or high energy trauma in younger age group. Different surgical options used to treat and fix this fractures that could be Intramedullary devices like intramedullary nail or extramedullary devices like fixed angle blade plate.
Objective: Comparing the result of close reduction and internal fixation with intramedullary nail to the open reduction and internal fixation with 95-angled blade plate for treatment of subtrochanteric fractures.
Methods: Prospective multicenter study was done in Al-Imamein Al-kadhimein Medical City and Al-Wasity Teaching Hospital for thirty patients with close and open (Gustilo type-1) subtrochanteric femoral fractures between December-2014 and September-2016. Eighteen patients (8 closed + 10 open fractures) treated with Intramedullary nail (IMN) were compared to twelve patients (9 closed + 3 open fractures) treated with open reduction and 95-angled blade plate fixation (BP).
Results: There were significant statistical differences between the two groups. The IMN group show better outcome regarding the mean union rate time (IMN were 16 weeks while in the BP were 22 weeks). Mean hospitalization stay (IMN were 82 hours while in BP were 110 hours) and rate of infection (IMN 0% while in BP were 16%), but no statistical difference regarding the mean operation time (IMN were 1.59 hour while in BP were 1.43 hour) and functional outcome (HHS in IMN were 82 while in BP were 79).
Conclusion: Closed reduction and internal fixation with Intramedullary Nail is preferable (for Close and Open Gustilo’s type-1 Subtrochanteric fractures) when compared to the open reduction and Internal Fixation with 95-angled Blade Plate.
Keywords: Subtrochanteric femur fractures, closed reduction intramedullary nail fixation, open reduction internal fixation, fixed angle blade plate.
Citation: Joda AI, Aldookhi AA, Abd Ali AS. Intramedullary nailing versus fixed angled blade plating for treatment of subtrochanteric femoral fracture. Iraqi JMS. 2018; 16(2): 125-132. doi: 10.22578/IJMS.16.2.3

Background:The prevention of preterm birth is a major health care priority.
Objective: To evaluate the efficacy of vaginal progesterone pessary in reducing the rate of preterm delivery and subsequent neonatal morbidity and mortality events in pregnant women with a short cervical length early in the 2nd trimester.
Methods: Women with a singleton pregnancy without a history of preterm labor nor a history of second trimester miscarriage, underwent cervical length measurement at 14+0 to 15+6 weeks of gestation. Women found to have a cervical length less than 30 mm received vaginal progesterone pessary (400 mg per pessary) on daily basis, or no treatment. Primary outcome was preterm delivery rate before 37 weeks gestation. Secondary outcome includes neonatal morbidity and mortality events.
Results: From the 7725 pregnant women screened between the period from April 2015 to January 2017, 613 were found to have a cervical length less than 30 mm and only 518 pregnant women met the inclusion criteria and agreed to participate in this study. However, only 492 were followed up till the time of delivery. From those 252 women administered 400 mg vaginal progesterone pessary once daily at night and the remaining 240 women did not receive any form of progesterone and served as control. There was a significant reduction in preterm delivery rate less than 37 weeks gestation among women receiving progesterone vaginal pessary compared to the control group 11 (4.4%) vs 38 (15.8%), p value < 0.001. Regarding neonatal outcome, there were significant reduction in the frequency of respiratory distress syndrome, low birth weight neonates and admissions to neonatal intensive care unit in women taking vaginal progesterone pessary compared to the control. While other neonatal morbidity and mortality events, incidence of neonatal congenital anomalies were not significantly different between the two groups.
Conclusion: Vaginal progesterone pessaries in women with a cervical length less than 30 mm early in the second trimester are found to be effective in reducing the rate of preterm birth and some of the prematurity related morbidity events.
Keywords: preterm labor, vaginal progesterone pessaries, short cervix, premature delivery
Citation: Khazaali EAA. Vaginal progesterone pessary for preterm labor prevention in women with a short cervix early in the second trimester. Iraqi JMS. 2018; 16(2): 133-143. doi: 10.22578/IJMS.16.2.4

Background: Peripheral arterial disease (PAD) is one of the most common cardiovascular diseases in developed countries and is an emerging problem in developing countries. Duplex ultrasonography (DUS) has been used as the initial imaging modality in mild symptomatic PAD. Multi-slice helical CT angiography of arteries of the thigh represents a reliable means for the detection of relevant stenoses in patients with peripheral occlusive artery disease.
Objective: To assess value of multi-detector computed tomography angiography (MDCTA) and to compare it with DUS to diagnose chronic ischemia of lower limbs.
Methods: A prospective comparative study was conducted on 30 patients with chronic lower limbs ischemia of both limbs during the period from September 2015 to September 2016 at the Department of Diagnostic Radiology of Al-Imamein Al-Kadhimein Medical City, Baghdad, Iraq. DUS was done for all the patients and then MDCTA was done.
Results: Thirty patients (20 males and 10 females) with a mean age of 57.1 ± 8.5 (range: 33 –80) years were included in this study. MDCTA detects 69 lesions (41 occluded segments and 28 stenotic segments) and DUS detects 58 lesions (35 occluded segments and 43 stenotic segments). In MDCTA, 8 patients (26.7%) had lesion in only one arterial segment, 13 patients (43.3%) had two segment lesions, 3 patients (10%) had three segment lesions, 4 patients (13.3%) with four lesions and only two patients (6.7%) had lesions in five arterial segments. Regarding the findings of the DUS one segment lesion was detected in 13 patients (43.3%), two segment lesions in 11 (36.7%), three segment lesions in 2 (6.7%), four segment lesions in 3 (10.0%) and only five segment lesions in only one patient (3.3). Furthermore, the measure of agreement between both MDCTA and DUS in the number of lesions detected revealed a good agreement between both tests, (Kappa = 0.81) with a percent agreement of (86.6%).
Conclusion: Multi-detector CT angiography is a fast, accurate, safe and a minimally-invasive imaging modality which may be used in cases of PAD for diagnosis, grading and for preoperative assessment of lower limb arterial disease.
Keywords: Multi-detector CT Angiography, chronic ischemia of lower limbs, doppler ultrasound
Citation: Kadhim MA, Eisa YA, Mohammed SJ. Value of multi-detector CT angiography in chronic ischemia of lower limbs in comparison with the doppler ultrasound. Iraqi JMS. 2018; 16(2): 144-151. doi: 10.22578/IJMS.16.2.5

Background: Cervical spondylosis myelopathy (CSM) is a common cause of disability in older persons. Because spondylosis is a universal finding as the patients aged.
Objective: To assess the demographic and management of cervical spondylosis in a sample of Iraqi patients.
Methods: This is a prospective clinical study, carried out over the period from January 2013 to December 2014, and included 25 patients with cervical spondylosis myeloradiculopathy referred for surgical intervention in Neurosurgical Department in the Al-Imamein Al-Kadhimein Medical City. General examination and full neurological assessment were performed, as well as relevant investigations, particularly; radiological assessments. All of the patients were subjected to surgery, with 17 patients (68%) were treated with laminectomy and foraminotomy, while the remaining 8 patients (32%) were treated with laminectomy only.
Results: They were 14 males and 11 females, slightly affects males more than females, aged 38 to 82 years it is more common in 5th and 6th decades of life, and in rural than urban areas. Myeloradiculopathic features were the most common presenting ones with C5-C7, which were the most affected levels. General examination and full neurological assessment were performed, as well as relevant investigations, particularly; radiological assessments. All of the patients were subjected to surgery, with 17 patients (68%) were treated with laminectomy and foraminotomy, while the remaining 8 patients (32%) were treated with laminectomy only. More than half of the patients were showed slight improvement in their complaints, while significant improvement occurred in more than 28 % of patients. Despite that, 20% of patients showed no improvement in their symptomatology, however; no reported deterioration was noticed in the study.
Conclusion: Myeloradiculopathic feature were the most common presenting features with C5-C7 was the most level affected. Laminectomy with foraminotomy was surgery of choice in tow third of patients, with remaining one third underwent laminectomy only.
Keywords: Cervical spondylosis, spinal cord compression
Citation: Jaizany AJA, Nema IS, Hassan YM. Assessment of spinal cord compression in patients with cervical spondylosis, a clinical prospective study of 25 patients. Iraqi JMS. 2018; 16(2): 152-158. doi: 10.22578/IJMS.16.2.6

Background: Cancer stem cell markers known for their ability to induce tumor initiation, angiogenic activity, therapy resistance and metastasis formation. Plant extract potentially was used to treat cancer and/or target its genes. Cyperus rotundus tubers extract has been used in ancient as a folk medicine for its antibacterial, anti-diabetic and for other maladies for its antioxidant properties that have been estimated in modern medicine.
Objective: To determine the effects of total oligofalvonoids (TOF) extracted from Cyperus rotundus tubers against cervical cancer cells line (HeLa) and human glioblastoma (AMGM) cell line.
Methods: Cytotoxicity of TOF extract against both cancer cell lines was determined after 24 hr of exposure and the best concentration of inhibition was 350 µg/ml. Total RNA extracted from both cell lines after treated with TOF and the expression levels of cancer stem cell markers OCT3/4 as well as matrix metalloproteinasese MMP2 and MMP9 have been measured using quantitative real time polymerase chain reaction.
Results: Cytotoxicity of TOF extract with concentration (350 µg/ml) shown to reduce the growth of cancer cell lines after 24 hr of exposure. The expression level of OCT3/4 was highly significantly reduced in both AMGM and HeLa cells after treated with TOF and the fold change reduced from (15 to 0.03) and (10 to 0.09), respectively. On the other hand, the expression levels of MMP2 and MMP9 were significantly decreased in AMGM and HeLa cells treated with TOF extract with decreasing in fold change from (10.2 to 0.02) for MMP2 in AMGM cells and (1.85 to 0.5) for MMP9. And fold change of MMP2 expression in HeLa cells was decreased after treated with TOF from (11.1 to 0.01) and for MMP9 (11.43 to 0.08).
Conclusion: The result indicates that the inhibition of cancer stem cell markers OCT3/4 and MMP2 and MMP9 may provide a novel strategy to treat cancer using a natural plant extract.
Keywords: Cancer stem cell markers, AMGM cells, Hela cells
Citation: Abdulghany ZS, Mahmood NA, Tawfeeq AT, Yassen NY. Cyperus Rotundus Tubers extract inhibits stem cell markers expression in cervical and human glioblastoma cancer cell lines. Iraqi JMS. 2018; 16(2): 159-165. doi: 10.22578/IJMS.16.2.7

Background: Perianal fistula accounts for 0.01% of general population and is frequently managed inadequately resulting in a significant morbidity. Magnetic resonance imaging (MRI) plays an essential role in the preoperative assessment of the disease, therefore improving post-operative surgical outcome.
Objective: To study the role of MRI in the evaluation of perianal fistula and to show the value of using contrast enhanced MR study in the determination of the precise tract pathway, extensions and other associated pathologies.
Methods: A cross sectional analytic study was conducted on a total of 32 patients with perianal fistulas in the MRI Department of Al-Imamein Al-Kadhimein Medical City, Baghdad, Iraq during the period from November 2015 to December 2016. Patients underwent MRI examination using axial and coronal T2 weighted images with and without fat suppression and T1 fat suppressed sequences before and after contrast administration. The type of fistula, location of the internal opening, associated abscesses and/or sinus tracts and horseshoe extension were evaluated using different MR sequences.
Results: The most common type of fistula encountered was the inter-sphincteric type, which was seen in 21 patients (66%), of those patients 16 fistulas (50%) were grade I and 5 fistulas (16%) were grade II. Trans-sphincteric fistulas were seen in 9 patients (28%), 2 of them (6%) were grade III and 7 fistulas (22%) were grade IV. Two patients (6%) had extra-sphincteric type. T2 weighted TSE, T2 TSE with fat suppression and T1 weighted fat suppressed post contrast sequences all show significant correlation with surgical results (with p-value less than 0.05) and the highest significance was obtained by the post contrast sequence (p-value of 0.00001). The highest accuracy in the diagnosis of fistula in ano was with the use of T1 enhanced fat suppressed sequence (98.8%) followed by 87% for the T2 fat suppression sequence and only 57% for the T2 weighted TSE sequence.
Conclusion: MRI is an essential, noninvasive tool in the preoperative assessment of perianal fistulous tracks, with the axial and coronal post contrast fat suppression T1 providing the highest accuracy and clinical significance with surgical data and therefore giving a highly promising decrement in the incidence of post-operative complications.
Keywords: MRI, perianal fistula
Citation: Jawad AM, kadhim MA, Al-Jobouri ZK, Hussain MAA. The value of magnetic resonance imaging in the evaluation of peri-anal fistula. Iraqi JMS. 2018; 16(2): 166-176. doi: 10.22578/IJMS.16.2.8

Background: Akt, is a serine/threonine protein kinase which act as an important regulator of cell proliferation and survival. The Akt complex is upregulated by phosphorylation producing phospho-Akt, which trigger a continued cell proliferation and survival and inhibit apoptosis, thereby promote cell survival.
Objective: To evaluate the immunohistochemical expression of phosphorylated Akt (Phospho-Akt) in laryngeal squamous cell carcinoma (SCC) and to be correlated with different clinicopathological parameters.
Methods: Phospho-Akt expression was investigated Immunohistochemically in 49 formalin-fixed paraffin embedded laryngeal SCC tissue sections collected from Teaching laboratories - Baghdad Medical City.
Results: Phospho-Akt positive immunostaining appears in 57% of samples. Akt activation present in advanced stages of tumors with p value 0.02.
Conclusion: The current findings may provide evidence that aberrant expression of Akt contributes to the pathogenesis (mechanism of disease development) of laryngeal SCC.
Keywords: Akt, phospho-Akt, immunohistochemistry, laryngeal SCC, larynx
Citation: Wanas NS, Mehdi LY, Alzubaidi LKA. Evaluation of phospho-AKt immunohistochemical expression in patients with laryngeal squamous cell carcinoma. Iraqi JMS. 2018; 16(2): 177-181. doi: 10.22578/IJMS.16.2.9

Background: Gaucher disease (GD) is an inherited autosomal recessive disease. It is most common in the Ashkenazi Jewish population. Many biomarkers might be involved in the etiology, pathogenesis, diagnosis and prognosis of GD in children. Most of them are related to complications due to an involvement of many organs such as liver, spleen and bones by this lysosomal storage disease that caused by a lack of the enzyme glucocerebrosidase.
Objective: To investigate the role of kidney function test and electrolytes (urea, creatinine, sodium and potassium) level in the monitoring of the response for the treatment used for patients with GD in follow-up manner.
Methods: A case control study was done on 67 children (32 males & 35 females), age range from 2-14 years (mean±SD; 5.3±2.9). The levels of sodium, potassium, urea and creatinine were measured in the samples of patients who were categorized as newly diagnosed untreated patients (n=9), patients receiving enzyme replacement therapy (ERT) for 3-6 months (n=18), 6-12 months (n=20) and patients receiving ERT for more than one year (n=20) and compared with twenty age-matched control subjects (9 males & 11 females) age range from 2-14 years (mean±SD; 5.55±3.05).
Results: The data indicated that the level of urea in GD patients (23.39±4.71 mg/dl) was significantly higher than that of age-matched controls (17.5±3.05 mg/dl). Non-significant differences were illustrated in the levels of sodium, potassium and creatinine. Negative significant (p<0.05) correlations were obtained between the levels of urea (r= -0.752; p<0.001) and creatinine (r= -0.536; p<0.001) with the period of receiving ERT. Additionally, ANOVA test also revealed significant (p<0.05) differences among the patients' subgroups in the levels of urea and creatinine. Results obtained from Receiver Operating Characteristic (ROC) curve revealed that urea and creatinine showed a high area under the curve (AUC), sensitivity and specificity (0.939, 77.8% and 85% for urea and 0.978, 100% and 80% for creatinine respectively) in newly diagnosed GD patients in a comparison with control.
Conclusion: The possibility of using urea and creatinine in the diagnosis and monitoring the effect of ERT on the GD patients.
Keywords: Gaucher disease, macrophage, renal function test, urea, creatinine, sodium, potassium, enzyme replacement therapy, imiglucerase, β-glucocerebrosidase, glucocerebroside
Citation: Abdulhussein HA, Al-Obaidi FH, Arif HS. The effect of the enzyme replacement therapy on the kidney function tests and serum electrolyte levels in children with Gaucher disease. Iraqi JMS. 2018; 16(2): 182-190. doi: 10.22578/IJMS.16.2.10

Background: Ketamine is N-methyl-D-aspartate (NMDA) receptors blocking drug, it affects the cerebral cortex and play an essential role in learning and memory. Amyloid β (Aβ) is a cleavage product of a large, trans-membrane protein, termed amyloid precursor protein (APP); it may have a role in controlling synaptic activity.
Objective: To investigate the immunohistochemical beta APP reaction in newborn mice frontal and parietal cerebral cortices after prenatal exposure to therapeutic doses of ketamine as an attempt for scientific judgments of making better understanding for effects of ketamine on developing brain, which may help to reduce adverse effects.
Methods: Thirty pregnant mice were divided into two groups named experimental and control groups (15 mice for each groups). The experimental group animals were injected intraperitoneally with 50 mg/kg ketamine, the control group animals were injected with intraperitoneal distilled water. Paraffin sections of newborn mice frontal and parietal cortices were stained immunohistochmically with anti-APP antibodies.
Results: The immunohistochemical labeling in the experimental group showed scattered clumps of brown staining distributed randomly in the cerebral cortex. The brown stained deposits vary also in shape and size, the larger and more intense staining was seen in the more superficial layers of the frontal cortex. The statistical analysis found non-significant differences in staining pattern between frontal and parietal cortices of control group, while significant differences were found between frontal and parietal cortices in experimental group.
Conclusion: The immunohistochemical APP reactivity showed different intensities and different morphology in the frontal and parietal cortices in the all experimental group animals were that injected with ketamine in this study. These differences could be related to the requirement of this substance in repair and differentiation of the developing NMDA dependent interneuron impaired by prenatal ketamine exposure.
Keywords: Frontal cortex, parietal cortex, amyloid precursor proteins, ketamine, prenatal, immnuohistochemistry
Citation: Najm MS, Mubarak HJ, Mohammed LH. Amyloid precursor protein immunohistochemical changes in the newborn mice frontal and parietal cerebral cortices affected by prenatal exposure to ketamine. Iraqi JMS. 2018; 16(2): 191-200. doi: 10.22578/IJMS.16.2.11

Background:In Iraq, breast cancer is the commonest type of malignancy in females. The disease is a genetically and clinically heterogeneous. The cholesterol metabolite 27-Hydroxycholesterol (27HC), a primary metabolite of cholesterol and an estrogen receptor (ER) and Liver X receptor (LXR) ligand, increases ER-positive breast cancer. 27-hydroxycholesterol (27HC) is metabolized by oxysterol 7α-hydroxylase (CYP7B1), CYP7B1 expression has been decreased in ER-positive tumors compared with normal breast tissues.
Objective:To study and investigate the possible association of clinic-pathological parameters 27HC and CYP7B1 level in sera of women with benign and malignant breast tumors and in control group by ELISA technique and Investigate the possible relationships of 27HC with CYP7B1.
Methods:This case control study was conducted on sixty patients with breast diseases were divided into three group, group I contained twenty patients with benign breast diseases, group II consisted of twenty premenopausal patients with breast cancer. Group III comprised twenty postmenopausal patients with breast cancer with the mean age and standard deviation (25.25±7.87, 38.65±6.28, 58.5±7.02 years). 27HC and CYP7B1 were measured in tissues by instrument ELISA technique.
Results:The tissue homogenates of women with premenopausal and postmenopausal breast cancer groups showed a significant elevation of 27HC in comparison with benign (p> 0.001), whereas there is no significant difference observed between both breast cancer groups (p= 0.542). The tissue homogenates of women with premenopausal and postmenopausal breast cancer groups showed a significant decrease of CYP7B1 concentration in comparison with benign (p= 0.003) and (p= 0.001), whereas there is no significant difference observed between both breast cancer groups (p= 0.868).
Conclusion:A higher incidence of 27HC and a lower incidence CYP7B1 were obtained in malignant than benign breast tumor tissues with positive estrogen receptors. These indicate that the levels of 27HC and CYP7B1 in breast tumor tissues may be used as new biochemical markers for breast tumor prognosis.
Keywords:27-Hydoxycholesterol, CYP7B1, breast cancer, estrogen receptor
Citation:Mohammed ZK, AL-Saeed HH, Nile AK. The level of 27-hydroxycholesterol and oxysterol 7α-hydroxylase (CYP7B1) in tissues of women with breast tumors. Iraqi JMS. 2018; 16(2): 201-206. doi: 10.22578/IJMS.16.2.12

Background: Legionella pneumophila (L. pneumophila) is gram-negative bacterium, which causes Legionnaires’ disease as
well as Pontiac fever.
Objective: To determine the frequency of Legionella pneumophila in pneumonic patients, to determine the clinical utility
of diagnosing Legionella pneumonia by urinary antigen testing (LPUAT) in terms of sensitivity and specificity, to
compares the results obtained from patients by urinary antigen test with q Real Time PCR (RT PCR) using
serum samples and to determine the frequency of serogroup 1 and other serogroups of L. pneumophila.
Methods: A total of 100 pneumonic patients (community acquired pneumonia) were enrolled in this study during a
period between October 2016 to April 2017; 92 samples were collected from patients attended and admitted
to Al-Imamein Al-Kadhimein Medical City and 8 samples from those in the (Center of Kidney Diseases and
Transplantation) in the Medical City of Baghdad. All patients were under therapy with antibiotics. Serum and
urine specimens were obtained from all patients; urine samples were processed for urinary antigen test (rapid
test). Serum samples were collected and submitted to DNA extraction for detection of L. pneumophila mip
gene by q RT PCR assay.
Results :The percentage of L. pneumophila in two hospitals in Bagdad was 30%. Of these 26% was serogroup 1
detected by urinary antigen testing (UAT). In the other hand, 23% of samples were positive by q RT PCR based
mip gene, of these 19 % were serogroup 1 and 4% were another serogroup. The sensitivity of UAT is high (P
value < 0.001), which means statistically highly significance than q RT PCR.
Conclusion : LPUAT is a rapid tool for early diagnosis of Legionella infection, which highlights the need of using this test in
hospitals and health institutions and there is a high prevalence of L. pneumophila in Iraq that refer to the
necessity of considering this microorganism point of view in future studies for detection and treatment in
pneumonic patients.
Keywords: L. pneumophila, mip gene, quantitative real time PCR, urinary antigen.
Citation :Gauad SA, Abdulrahman TR, Muhamad AK, Jawad AA, Hassan JS. Clinical utility of urinary antigen test and
molecular method for detection of Legionella pneumophila. Iraqi JMS. 2018; 16(2): 207-215. doi:
10.22578/IJMS.16.2.13

Background: Otitis media is a group of complex inflammatory disorders affecting the middle ear, which can be
acute or chronic. Otitis externa is an inflammation on the skin of the external auditory canal usually
associated with secondary bacterial and/or fungal infection of macerated skin and subcutaneous
cellular tissue.
Objective: To determine the effect of ginger extracts on bacterial isolates from patients suffering from otitis.
Methods: Two hundred patients suffering from suppurative otitis media and externa, who were attending to
ENT Department, Al-Imamein Al-Kadhimein Medical City. The powder of ginger rhizomes was
soaked with the solvent left in a shaking water bath at 40 °C for 24 hours and then filtered using
Whatman No.1 filter paper. Each extract was concentrated using a rotary evaporator with vacuum
to get the final crude extract after the procedure of ginger extract was done. The activity of this
extract was tested against bacterial isolates from patients with otitis.
Results: The results of this study revealed that otitis externa was less common infection than the other
types of otitis 29 (14.5%), while acute otitis media comprised 96 (48.0%), and chronic suppurative
otitis media consisted of 75 (37.5%). The most common bacterial isolates that caused otitis were
Pseudomonas spp. followed by Staphylococcus spp. The results showed that, there are different
effects among (chloroform, methanol, and aqueous) extracts of ginger against pathogenic bacteria.
Conclusion: Generally, ginger extracts had a good effect on isolated bacteria. Chloroform extract was the most
effective one, followed by methanol extract, while aqueous extract showed the least activity in this
regard.
Keywords: Otitis externa, otitis media, ginger extraction
Citation: Mohammed MM, Al-Attraqchi AAF, Al-Hasseni JMK, Sahib HB. The effect of ginger extracts on
bacterial isolates from patients with suppurative otitis media and externa: in vitro study. Iraqi
JMS. 2018; 16(2): 216-222. doi: 10.22578/IJMS.16.2.14

Background: Bacterial conjunctivitis is a microbial infection of the mucous membrane of the conjunctiva of eye
that occurs both in adults and children. It is produced by an array of microorganisms that is
frequently isolated from the conjunctiva of healthy subjects. The normal conjunctival flora
represents both bacterial colonization and transient or recurring bacterial contamination.
Coagulase-negative Staphylococci and Corynebacteria are frequently present on the healthy
conjunctiva, but more traditionally pathogenic organisms, such as coagulase-positive Staphylococci,
Streptococci, Haemophilus species, Moraxellae and Gram negative coliform rods occasionally
isolated from normal, non-inflamed eyes.
Objective: To determine etiological agents of aerobic bacterial conjunctivitis and the prevalence of each
bacteria and its relation with the conjunctival discharge.
Methods: This study conducted on 100 conjunctival samples from patients with conjunctivitis, and 50 samples
from healthy normal persons. All samples were cultured on enriched media like blood agar and
chocolate agar, anti-microbial susceptibility of all 100 samples from patients were analyzed.
Results: The prevalence of aerobic bacterial conjunctivitis is 53 %with predominance age of 1-10 years. The
most common bacterial isolates were Staphylococcus epidermidis followed by Streptococcus
pneumonia. Most of the isolates were sensitive to cefotaxime and ofloxacillin, while different result
was detected regarding resistance of each isolated bacteria.
Conclusion: Aerobic bacterial isolates can be detected both in conjunctivitis and normal healthy individual with
similarity regarding the type of bacteria that affect all age group.
Keywords: Conjunctivitis, commensal flora, conjunctival discharge
Citation: Anoar KA, HassanTM, Majid BT. Identification of common aerobic bacterial isolates among
conjunctivitis in Sulaymaniyah Province / Iraq. Iraqi JMS. 2018; 16(2): 223-229. doi:
10.22578/IJMS.16.2.15