IRAQI JOURNAL OF MEDICAL SCIENCES

Endometrial carcinoma is the second most common gynecological cancer in developing countries after cervical carcinoma and its incidence is increasing due to the rise in the rate of obesity. Diagnosis depend on invasive test (biopsy) with no routine screening investigation available for either general population or high-risk group, there are several types of biomarkers that can be used for diagnosis, prognosis and management but none are available for routine clinical practice. Following the discovery of the new gene-based classifications of endometrial cancer, the use of these gene-based biomarkers will be the cornerstone in the early diagnosis and management for endometrial carcinoma patients in the coming years.
Keywords:Endometrial carcinoma, screening, PTEN, miRNA, P53, circulating tumor DNA, genomic classification
Citation:Kareem NM. Genomic biomarkers in endometrial carcinoma. Iraqi JMS. 2019; 17(2): 100-102. doi: 10.22578/IJMS.17.2.1

Background:Atopic dermatitis (AD) is a common inflammatory skin disease with a chronic relapsed-remitting course with manifestations started at early childhood. AD is two types; extrinsic and intrinsic. Zinc has a crucial role in the immune system functions and antioxidant mechanisms, it also serves in the metabolism and cell growth through signaling several enzymes.
Objective:To assess serum zinc level in patients with childhood AD.
Methods:A case-controlled study was conducted in Dermatology outpatient’s clinic in Al-Imamein Al-Kadhimein Medical City, from the period of September 2016- June 2017. Twenty patients with AD were enrolled in this study. AD severity was graded using the Scoring Atopic Dermatitis Index (SCORAD). The control group consisted of age-matched and sex-matched twenty healthy children were taken with weight above 80%. Fasting blood samples were taken from patients and controls between 8 AM and 10 AM.
Results:Of the twenty patients of AD, 13 (65%) were males and 7 (35%) were females. Their mean age was 4.58±3.13. Regarding the control group 9 (45%) were males and 11 (55%) were females, their mean age was 4.29±2.46. No statistical difference in serum zinc level between AD patients and control groups. Concerning zinc level in males and females, no statistical differences was found in AD patients, but highly significant difference was found in control group. Serum zinc level was highly significantly low in patients with moderate AD than in those with mild AD. There was negative correlation between serum zinc level and severity of AD.
Conclusion:There is a negative correlation between serum zinc level and severity of AD, also there is a gender variation in serum zinc level in normal children.
Keywords:Serum zinc level, atopic dermatitis
Citation: Farhood IG, Ahmed MA, Al-Bandar RT, Farhood RG. Assessment of serum zinc level in patients with atopic dermatitis. Iraqi JMS. 2019; 17(2): 103-107. doi: 10.22578/IJMS.17.2.2

Background:The incidence of cancer is increasing worldwide. Xanthium strumarium may possess anticancer activity, the plant extract for in vitro anticancer activity against a panel of three human cell lines (Breast MCF7, Renal TK10 and Melanoma UACC62), exhibit anticancer activity against these three human cell lines screened by National Cancer Institute.
Objective:To investigate the safety of chloroform extract of Xanthium strumarium leaves, which showed potent cytotoxic activity against tumor cells.
Methods:The leaves were dried and grounded into fine powder, and extracted with chloroform, that showed potent cytotoxic activity has been tested against two animal species mice and rats for testing its safety. Toxicity was evaluated in Swiss albino mice by feeding with serial doses of extract between 1.0 to 20.0 gm/kg orally and observed continuously for the first 4 hr and hourly for the next 24 hr, then every 6 hr for 48 hr (72 hr, acute toxicity). Rats were also fed with extract single dose of 5 gm/kg, the toxicity was carried out by assessing the effects on biochemical parameters, body weight and relative organ weights for both male and female rats.
Results:LD50 of chloroform extract was 3.07 gm/kg. The biochemical finding showed no significant differences compared to control. No significant weight changes occur throughout the study.
Conclusion:Chloroform extract has low LD50 (3.07 gm/kg), but the acute toxicity study showed no mortality or signs of toxicity, with non-significant changes in body weights, relative organ weights, and biochemical tests among treated groups compared to their controls.
Keywords:Xanthium strumarium, chloroform extract, cytotoxic herb, acute toxicity
Citation:Alsabah AS, Abd AH, Al-Shammari AM. Acute and subacute toxicity of chloroform extract of Xanthium strumarium leaves. Iraqi JMS. 2019; 17(2): 108-113. doi: 10.22578/IJMS.17.2.3

Background:The World Health Organization considered obesity as a medical condition that may lead to reduced life expectancy and/or increased health problems. While much of the focus on the impairments caused by obesity is on somatic health, recent data suggest that reproductive health may also be impacted.
Objective:To quantify the relation between obesity and the reproductive hormones.
Methods:This cross-sectional study was carried out at nutrition clinic in three teaching hospitals and one obesity clinic in a medical college in Baghdad. The body mass index (BMI) calculation, blood sugar, serum cholesterol, triglyceride, testosterone, prolactin, follicular stimulating hormone (FSH), and luteinizing hormone (LH) were measured.
Results:Ninety-five adult obese males participated in this study. Serum testosterone had significant negative correlation with BMI, weight, serum cholesterol, and serum triglyceride while serum LH had significant positive correlation with BMI (p value was 0.013), weight (p value was 0.027), and serum triglyceride (p value was 0.049).
Conclusion:Male obesity has significant effect on serum level of testosterone and LH.
Keywords:Obesity, reproductive hormones
Citation:Abdul-Rahman IM., Abdul-Ameer AJ. Reproductive hormonal assay of a sample of Iraqi obese males. Iraqi JMS. 2019; 17(2): 114-119. doi: 10.22578/IJMS.17.2.4

Background:Metabolic syndrome is associated with obesity, which is a common condition in subfertlie women population. For that reason, the infertile women will be more predisposed for cardiac diseases.
Objective:To know the prevalence of the metabolic syndrome among subfertile women in Mosul, a city in the north of Iraq.
Methods;Seventy subfertile females aged >17 years were selected randomly. Adult Treatment Panel-III (ATP-III) guidelines was used for diagnosing metabolic syndrome. The diagnosis was done if any three of the following were present: central obesity, raised triglycerides ≥150 mg/dl, low high-density lipoprotein (HDL-C) cholesterol, blood pressure ≥130/≥85 mmHg, and diabetes or fasting serum glucose (FSG) ≥100 mg/dl.
Results:Metabolic syndrome was diagnosed in 16 (22.85%) women. The prevalence was 15.8% in the population younger than 30 years and 55.5% in ages more than 30 years. Fifty percent of women with class II obesity had metabolic syndrome. The most common abnormality was the abnormal waist circumference (100%). Patients having metabolic syndrome had three components of the syndrome and none had four or five components at the same time.
Conclusion:The prevalence of metabolic syndrome is high among subfertile women. Focus of cardiovascular prevention should be undertaken for these subjects.
Keywords:Metabolic syndrome, infertility, polycystic ovary syndrome, diabetes, obesity
Citation:Jarjees YT, Hassan ZMA, Al Dabbagh EH. Frequency of metabolic syndrome in subfertile female population in Mosul. Iraqi JMS. 2019; 17(2): 120-125. doi: 10.22578/IJMS.17.2.5

Background:Lumbar spinal canal stenosis results from compression of spinal cord and/or nerves at any level of lumbar vertebra. The relationship between clinical features of the patients and the degree of stenosis is not clear and there is no accepted “gold standard” for the diagnosis of lumbar stenosis.
Objective:To evaluate the relationship between the degree of radiologically confirmed stenosis and the severity of Oswestry disability Index and to assess the most valid parameter for the diagnosis of the lumbar stenosis.
Methods;A cross-sectional study conducted on randomly selected patients with lumbar stenosis at Magnetic Resonance Image Unit of Al-Imamein Al-Kadhimein Medical City in Baghdad from May to September 2018. All patients filled Oswestry disability Index questionnaire and underwent examination using 1.5 Tesla magnetic resonance unit (Avanto, SIEMENS).
Results:A total of 41 patients were included (51.46±12.62) years of age. The measurements of spinal canal including the cross-sectional area of dural sac at intervertebral levels, stenosis ratio, and depth of lateral recesses are found to be correlated significantly with the level of disability assessed by Oswestry disability Index. At all levels, neither the cross-sectional area of the lateral recesses nor Ligamentous interfacet distance correlated significantly to the level of disability.
Conclusion:Magnetic resonance image measurements of spinal canal correlated to the level of disability. Stenosis ratio and cross-sectional area of dural sac at intervertebral disc were more sensitive measurements for lumbar stenosis than other parameters.
Keywords:Oswestry disability Index, Spinal stenosis, magnetic resonance image
Citation:Al-Jaberi HKH, Shakir BK, Hjazeen AA. Validity of MRI measurements in lumbar spinal canal stenosis. Iraqi JMS. 2019; 17(2): 126-134. doi: 10.22578/IJMS.17.2.6

Background:Breast cancer has a major impact on health of women worldwide and Yemen is not in exception. Fingerprints play an important role, which is highly individualistic and could be recognized as a powerful tool in diagnosis of various diseases, furthermore, their medico-legal importance.
Objective:To study the clinico-pathological aspects of breast cancer and the role of fingerprints as screening test.
Methods:Prospective study of 68 female patients with breast cancer came to modern histopathology laboratory - Aden during the period from January - June 2018. All the patients suffering from breast lumps were referred for Fine Needle Aspiration Cytology diagnosis as well as fingerprints of their both hands were taken.
Results:Most of the participants (45.6%) aged between 40-49 years old, females from urban areas consisted 57.4%, and about 51.5% of females in this study were illiterate. Females who had 1-3 child consisted 33.8%. Regarding the breast lump, 54.4% of females had tumor size 2-5 cm, while skin change and fixed tumor to skin presented in same rate (14.8%). No pain and no nipple discharge present in 85.2% and 91.2% respectively in females' study. The females with palpable axillary lymph nodes and right breast side tumor consisted the same percentage (58.8%). Regarding the result of fine needle aspiration cytology, the invasive ductal carcinoma presented with high rate (85.3%), while stage II present with 36.8%. In relation to the finger print patterns; the loop patterns presented high rate in the little digit with 30.4%, while whorls patterns presented in index digit in 33.6% of patients. The loops and whorls patterns revealed significant association with breast cancer with a P-value of 0.005 and 0.028 respectively.
Conclusion:The social, behavioral, and hereditary factors play an important role in the development of breast cancer in addition to reproductive history, beside that the fingerprints are genetically determined factors that can be used as simple and cost-effective screening test for breast cancer.
Keywords:Breast carcinoma, fingerprints, Dermatoglyphic, forensic, Yemeni female.
Citation:Bin Thabit MA, Abdullah NA, Alnoban MS. Breast Cancer in a sample of Yemeni female patients: forensic dermatoglyphic traits and clinico-pathological features. Iraqi JMS. 2019; 17(2): 135-145. doi: 10.22578/IJMS.17.2.7

Background:The oxidative stress is one of the main reasons for cardiovascular diseases and also one of results of these diseases, its development (like kidney disease).
Objective:To identify the effect of oxidative stress nitric oxide and reactive oxygen species on cardiovascular diseases.
Methods:The study involved 56 subjects comparable in age and sex divided into two groups; 28 hypertensives subjects with kidney disease and 28 apparently healthy subjects as control group. The following analysis was done: 4-Hydroxy-2-nonenal (4HNE), Induced nitric oxide synthase (iNOS) and albumin.
Results:There was a significant increase in (4HNE) between patients' group and control group. iNOS was significantly higher in patients as compared to controls while there were no significant differences found in albumin between patient and control group. There is a positive relationship between oxidation results from hypertension and their developments. There is a positive correlation between BMI and disease.
Conclusion:Based on this study is important on ideal weight, because obesity considered main factors for heart disease and hardening of the arteries. In addition, the effect of oxidative stress, which leads to high blood pressure and thus chronic kidney disease.
Keywords;Chronic kidney disease, hypertension, 4-Hydroxy-2-nonenal (4HNE), Induced nitric oxide synthase (iNOS), albumin, creatinine, reactive oxygen species
Citation:Hammed AD, Jawad AH, Ali NM. 4-Hydroxy-2-nonenal, induced nitric oxide synthase status in hypertension with kidney disease patients. Iraqi JMS. 2019; 17(2): 146-152. doi: 10.22578/IJMS.17.2.8

Background:Motor unit number estimation (MUNE) is a unique electrophysiological technique that was developed to determine a numeric estimate of the number of innervating axons. This technique can be used to determine the approximate number of motor neurons in a muscle or group of muscles.
Objective:To test the MUNE values according to subject’s gender and hand dominancy in the normal population.
Methods:Healthy volunteers who had neither neuromuscular nor systemic/ metabolic disease, with normal neurological examination were studied. Ninety hands of 56 healthy volunteers (11 males and 45 females) with ages ranging from (24-58) years were included in the study. All had normal median nerve conduction studies. Manual incremental (INC) method and adapted multiple points stimulation (AMPS) method were performed for MUNE.
Results:Gender did not have an effect on the scores according to the two studied methods (p=0.054 by INC method and p= 0.700 by AMPS method). Hand dominancy also show no statistically significant difference of the scores of MUNE according to both studied methods (p=0.091) by INC method and (p=0.051) by AMPS method.
Conclusion:Incremental stimulation and adapted multiple point stimulation are reliable and easily applicable methods with same reproducibility in estimating motor units with no significant effect for subject gender or hand dominancy.
Keywords:Motor unit, motor unit number estimation (MUNE), incremental stimulation (INC) method, adapted multiple point stimulation (AMPS) method
Citation:Abdul Muneem SD, Kaddori HG. The effects of gender and hand dominancy on motor unit number estimation in a sample of healthy Iraqis using two different methods. Iraqi JMS. 2019; 17(2): 153-160. doi: 10.22578/IJMS.17.2.9

Ganglion is defined a cystic lesion composed of myxoid matrix having jelly like consistency and is lined by pseudomembrane. Large ganglionic cyst in Hoffa Pad is quite uncommon and only few are mentioned in literatures.
A 25-year old female presented with history of gradually worsening anterior knee pain and swelling for 10 months duration, she was disabled due to repeated attacks of knee pain. Magnetic resonance imaging (MRI) shows large intra-articular multilocular cyst. The decision was to do open excision of the cyst in order to decrease the recurrence rate. Histopathological finding shows multi-lobulated cysts with glassy fibrous wall and clear jelly like consistency, which confirm diagnosis. Postoperative period was uneventful and she was doing well during follow up after four months.
Large ganglionic cyst developed in Hoffa fat pad of the knee should be considered in deferential diagnosis of intraarticular mass causing pain around the knee. The decision was open excision depending on MRI finding to avoid incomplete resection and prevent recurrence.
Keywords:Knee, Ganglion Cyst, Hoffa Fat Pad, MRI
Citation:Dagher AE, Hasan FK. Large Intraarticular Ganglion in Knee Joint: A case report. Iraqi JMS. 2019; 17(2): 161-165. doi: 10.22578/IJMS.17.2.10