Mustansiriya Medical Journal

Background: Ginseng and nigella sativa produced different central
effects separately but the combined effects not studied previously.
Aims: This study aimed to shows the separated and combined effects
of Ginseng and Nigella sativa on the psychomotor performance.
Subjects and method: 20 healthy volunteers (15 males + 5 females)
enrolled in this study, they were medical college students, and their
ages were 20 – 21 year with mean of 20.2±0.41. Each volunteer do the
psychomotor performance before and after each selected agents.
Results: The result showed ginseng produce significant improvement
in all parameters of psychomotor performances, while the nigella
improves only the choice reaction time and produces insignificant
changes on other parameters. The combined action of ginseng and
nigella produced significant improvement in all psychomotor
performances parameters. Conclusions: From these results, we can
conclude, that combined effect of ginseng and nigella sativa produced
significant effects more than ginseng alone and removed the
inhibitory action of nigella sativa, also nigella sativa modulate the
stimulatory action of ginseng, regarding the choice reaction time
which reflect the cognitive function improvement.

Background: Gum specimens were collected from the labial vestibule of
mouth using swabs and sterile cotton were submitted to standard
microbiological technique for the isolation and characterization of
bacterial isolate. Aims: to estimate the carriage rate of streptococcus
spp. on gum of healthy population. Patients and Methods: This study
was conducted in the College of Health and Medical Technology and
Teaching Laboratories of Medical City for the period from 1st September
2010 15th April /2011. A total of 757 participants were included .They were
chosen randomly form staff and students of Health and Medical
Technical College. Results: 69% of normal healthy individuals were carrier
for Streptococcus spp. in the labial vestibule rate between male and
female participants (64% vs 5%), (P<0.05), there was significant
difference in the gum carriage of streptococcus Mutans rate were 17%
between male and female participants (16% vs 1%), (P<0.05). However,
the age group between (18-20 years) showed higher carriage of
Streptococcus salivarius. The study also found that there was significant
difference between the age group (18-20) which showed higher carriage
of Streptococcus mutans rate compared to other age groups. On the
other hand, slightly higher carriage rate was established among rural
compared to urban population (341 % vs 416%), (P>0.05). In addition,
smoker participants (only male) had higher significant carriage rate in
comparison with non –smokers (62.3% vs 37.7%), (P>0.05). Conclusions:
considerable proportion of healthy population carries Streptococcus
species (spp.) in their labial vestibule.

Objective: To evaluate the frequency, clinical, and laboratory features of
HPS and to determine their usefulness in its diagnosis in Iraqi patients
with liver disease.
Patients and Methods: Fifty-two patients with chronic liver disease were
evaluated for the presence of HPS using pulse oximetry, arterial blood
gas
analysis
(ABG),
and
transthoracic
contrast-enhanced
echocardiography (CEE). Patients with SaO2 of ≤92% and/or a decrease in
SaO2 of ≥4% after change from supine to upright position; were further
tested with ABG and CEE. Patients who had a PaO2 of ≤70 mmHg
together with positive CEE were considered to have HPS.
Results: Of 52 patients studied, 13 (26.9%) were in Child-Pugh class A, 16
(30.7%) in class B, and 23 (42.3%) in class C. Four patients (7.6%) proved to
have HPS; one was in Child-Pugh class B and the other three were in class
C (p=0.3574). Among the clinical features assessed as predictors of HPS,
dyspnea (p = 0.0027), cyanosis (p < 0.0001), and finger clubbing (p =
0.0514) reached statistical significance. Neither upper GI endoscopy nor
biochemical liver tests were statistically different between patients with
and without HPS.
Conclusions: HPS is not rare. Dyspnea is a useful marker for its presence
in the appropriate clinical setting. Platypnea, cyanosis, and finger
clubbing are much less sensitive but more specific features of the
syndrome. No particular pattern of biochemical liver tests is useful in
predicting the presence or absence of HPS. There was a trend for HPS to
occur in patients with more advanced liver disease.

Background: breast cancer In Iraq is the commonest tumor affecting
females accounting for more than 18% in 2007 of registered female
cancers with increase incidence in young women.
Aims: the study aims to outline
the correlation between
histopathological grading of breast cancer cells with the ipsilateral
A.L.N involvement in relation to the size of cancer.
Patients & methods: A continuous prospective study where by almost
all mastectomized patient for breast cancer in Al- Yarmouk Teaching
Hospital were included from January 2008 to January 2011, revision to
all histopathological reports in the histopathological department was
done , tables were made and the P value was calculated.
Results: Breast cancer cases represent 28.1% of breast surgery in this
Hospital during the period of study. The commonest age group was the
5th decade 36.9% followed by the 4th decade 23%. Urban cases more
than rural area cases, (I.D.C) 81.5% and (I.L.C) 18.5%.
Regarding The histological grading grade II came first 70.8% grade III 20%
and grade (I) 9.2%, A.L.N involvement 100% in grade (III), 65.2% In grade
(II) and 33.3% in grade I.
Breast cancer size 2-5 cm represent 63% of The cases, tumor size more
than 5 cm represent 30% and those with size less than 2 cm 6.3%.
Conclusions: Breast cancer cases represent 28.1% of total breast surgical
disease for the same period of time done in this hospital and this is an
important percent which reflect the need for increased emphasis on
early detection by clinical and mammographic method or U/S study.
Key Words: breast cancer, histopathological grade, axillary lymph node
involvement

Introduction: An adequate analgesia during labor is important to
minimize the deleterious effects of sever labor pain on maternal and
fetal condition and also on the progress of labor.
Aims: To compare the clinical effectiveness of inhalational analgesia by
using Entonox versus systemic analgesia by using I.V pethidine for pain
relief in the first stage of labor.
Patients and methods: 48 multiparous women were selected in the first
stage of labor, were randomly allocated into 2 groups, group A had
received I.V pethidine and group B had received Entonox.
Total pain score measurement was done by using the parameters of Mc
Gill pain questionnaire which include pain rating index (PRI) and present
pain intensity (PPI).
Results: A comparison between group A&B done, the difference in PPI
between pethidine & Entonox was showing a statistical significance
P<0.001. The difference in PRI between pethidine &Entonox was carrying
no statistical significance.
Conclusions: Inhalational analgesia by using Entonox in a proper
intermittent technique is more effective than systemic analgesia by using
parenteral pethidine for reducing present pain intensity in the 1st stage of
labor.

Background: Stress hyperglycemia occurs in 5−30% of patients with
apoplexy, myocardial infarction, sepsis, trauma and other critical
illnesses, and it correlates with poor outcome. Aims: assessment of the
prevalence of admission hyperglycemia among acute coronary syndrome
patients and its impact on the outcome.
Patients and methods: Observational case control study had recruited
80 non-diabetic adults’ patients (43 males, 37 females) who were
randomly selected after admission to the CCU/department of medicine/
Al-Yarmouk Teaching Hospital in the period from March to October 2009
because of acute coronary syndrome. Detailed history and physical
examination were done, body mass index, waist-hip-ratio were recorded,
venous blood sample were taken from patients to measure plasma
glucose level and HbA1c; ECG and echocardiogram were done to all
patients included in the study.
Results: 80 patients (43 males, 37 females) completed the study, their
age groups ranging from 37-76 years, 3 patients were excluded from the
study (2 male, 1 female) when they found to have high HbA1c ( ≥6.5%). 16
patients (20.6% of total no.) (7 male, 9 female) with a mean age of
(62.19±7.17) were found to have casual admission (stress) hyperglycemic,
a p value &lt;0.05. Hyperglycemia is more likely associated with a female
gender, advancing age, higher BMI, android pattern of body fat
distribution, and higher killip classes (III, IV). Conclusions: Casual
admission (stress) hyperglycemia is not uncommon among non- diabetic
adults admitted for acute coronary syndrome. Poorer outcome in
patients with ACS is more likely among those with higher glycemic level,
especially with advancing age, female gender and increased total body
fat.

Background: There is rapid increase in bacterial resistance to
antibiotics resulted in increased morbidity and mortality among
patients in hospitals. Aims: monitoring of antibiotic resistance to
provide data for antibiotic therapy and resistance control prescription programs. Materials and Methods: Sixty seven clinical samples were
collected from urine, stool, pus, wound of the patients and operating
theater from some of Baghdad hospitals in 2010. Sixty two isolates of
Escherichia coli were detected by bacteriological and biochemical
tests, these isolates were submitted to hemolysis test and antibiotic
susceptibility to 10 kinds of antibiotic disks on Mueller Hinton agar by
disk diffusion method. The detection of β-lactamase production was
also done and Extended-spectrum beta-lactamase (ESBL) for all the
isolates. Results: Hemolysis test was positive for two isolates. All the
isolates of E. coli were resistant to ampicillin and cephalothin (100%)
and high resistance was observed to cephalixin (95.1%), tobramycin
(90.3%), doxycycline (82.2%) and nalidixic acid (70.9%). Both
ciprofloxacin and nitrofurantoin was (67.7%). Low resistance was
noticed to amikacin (11.2%) and trimethoprime (8.1%). β-lactamase test
was positive for 57 isolates (91.9%), while three isolates (4.8%) showed
positive result for extended-spectrum beta-lactamase.
Conclusions: Isolates of E.coli showed high resistance to
ampicillin,cephalothin and cephalixin. Low resistance was revealed to
amikacin and trimethoprime .Most of the isolates were positive for β
lactamase test (91.9%) and (4.8%) of the isolates were positive for
extended-spectrum beta-lactamase.

Background: The magnitude of free radical generation and their disposal
mechanisms are known to be altered in burn; and there is some kind of
correlation exists between altered free radical cascades and delay
wound healing. Aims: Exploration of the variable effect of N
acetylcysteine on Wound Healing in Burned Patients. Methods: 60
burned patients with different ages of both sexes and varying burn
percentage were involved in this study. Patients allocated into 2 groups:
A, B each group include 30 patients. Groups: B treated with antioxidant
N-acetylcysteine, compared with group A which is treated according to
hospital policy without antioxidant; also 30 healthy subjects (group C)
were involved in the study as control group for comparison.To each
group, serum malondialdehyde and serum glutathione levels,
microbiological examination, healing time and mortality rate were
measured depending on standard methods. Results: Administration of
N-acetylcysteine to burned patients produce significant reduction in the
wound healing time and improvement in mortality rate, compared to
group A, where no antioxidant was given. Conclusions: This study clearly
showed the beneficial effect of N-acetylcysteine in the treatment of
burned patients represented by shortening of healing time, in addition
to reduction in hospitalization period; it is recommended to add
antioxidant to the treatment list of burned patients.