Medical Journal of Babylon

Idiopathic congenital talipes equinovarus is the most common deformity of the foot. we report
our initial experience in using ponseti method for conservative treatment of club foot .we studied 42
patients with 62 club feet from July 2002-to-december 2006-in orthopaedic clinic in Al-Hilla teaching
hospital and in private clinic, age from 1st day to 10 months ,by serial correction and casting (2-8
times, for 7-10 days in each times).tendoachilles tenotomy is used in 6 cases only(with local or general
anesthesia),with follow up after treatment for one year, four patients(6feet were lost from follow up) .
we achieve 82% success rate, failure of correction is mainly related to poor compliance of the patients
to the cast , late presentation of the patient to the orthopaedic clinic, and the severity of deformity is the
third cause. Complications are only 5 cases including, fore foot swelling, cast slippage and skin
necrosis, all complications are treated. We think that ponseti method is a safe and effective treatment
for congenital idiopathic club foot and decreases the need for extensive surgical correction.

From Feb. 1999 to Feb. 2001, There were 1000 patients to be treated for burn in Hilla Surgical Teaching
Hospital burn unit in Babylon.
-596 male patients (59.6 %), 404 female (40.4 %).
-66o (66%) of cases were children, young adults 330 (33%), and old age group form 10 (1%).The vast
majority of cases fall in the group of moderate to major burns.
Flame burn formed 653 (65.3 %), 332 ( 33.2 % ) cases hotliquid ,and 15 (1.5 % ) sustained electric burn .100 patients (10 %) treated surgicaly.Hospital stay extended from 1-12 weeks.Bacterial study showed 54%
psuedomonas, staph. Aureus 22%, Klebsiella 13 %Proteus 9 % and E coli 2 %,175 patients died due to : -
inhalation injury 55%, septicemia 44%, G. I. bleeding one case.
The study has shown the burn injury problem as amajor national health problem , and prolonged
morbidity and temporary or perminant disability associated with it to result in astaggering economic drain
on social resources and finantial support is required.Prophylaxis against burn is better than
treatment.Teamwork approach to burn care is found to be of great importance.This study can be regarded as
amessage to whome it may concern.

spinal hydatid disease is rare, even in endemic areas that considered hydatid disease a significant problem.
Twelve cases of spinal hydatid were presented, and their management discussed. The authors reviewed
most of the recent literatures and proposed a simple classification for hydatid lesions in the spine. The
study stressed on consideration of this disease in the differential diagnosis of backache and spinal cord
compression in endemic areas before surgical intervention so that measures can be taken to decrease
complications and rate of recurrence.

Objective: This is study to evaluate the effects of combined oral contraception, low esterogen type on
some liver function , other physiological and biochemical charecterstics of the blood.
Study design&Setting: prospective b study atBabylon medical college teaching maternity
hospital,Department of Obstetric s& Gynecology,from july 2006 to june 2007.
Materials&methods: the study enrolled 330 women ,attending family planning center of the hospital.
They were divided into 2 groups, The study group of 250 women ( they were all pills usres for a
variable time), the control group of 80 healthy women ( were using natural methods of
contraception),Liver enzymes ALT,ALP, serum bilirubin , serum cholesterol, blood sugar , blood
pressure, body mass index were compared between both group , statistical analysis was carried out
using student t test, p value was calculated , any value more than 0.005 was considered not
significant.
Results:
The study revealed:
Ahighly significant (p significant change in bilirubin (p>0.005) when compared with the control group,
There was ahighly significant reduction ( p< 0.01) in HDL in the study group when compared with
the control group.
There was ahighly significant elevation ( p<0.01) in total cholesterol for the study group when
compared with the control group.
There was apositive correlation but it was non significant between the total cholesterol, HDL level (
R=0.2, P=0.001).
There was also ahighly significant elevation ( p<0.01) in the glucose level in the study group, and there
is apositive correlation between the mean glucose and total cholesterol in the study group.
There is a significant increase (P The study showed a highly significant change of body weight,an increase which is positively correlated
with the body glucose.
There is a highly significant increase for both systolic and diastolic blood pressure in pills usres. The body mass index shows a high significant increase for the study group which shows a significant
correlation with the mean body weight , mean systolic blood pressure.
Conclusion:
The study shows
1-The monophasic pills leads to changes in some liver function which on long term bases may leads to
a disturbance in acompletely healthy women or risk group.
2- The changes in body weight ,blood pressure, body mass inxdex may lead to a complication
as development of of obesity and future development of diabetes in a risky group.
3-Excess morbidity related to pills especially changes in serum cholesterol ,HDL, blood glucose
Which may accelerate atherosclerosis ,increased coronary vasospasm, the risk is more in smokers,older
women, family history of cardiovascular disease , longer duration of pills use.

A total of 720 clinical samples were collected from three main hospitals in Hilla city/ Babylon
province. Samples were screened for the presence of Raoultella spp., as well as studying their
expression of virulence factors. A total of 144 bacterial isolates were recovered and identified as
Klebsiella-like organisms. Out of these, 11 isolates were identified as Raoultella ornithinolytica, which
represent 7.6% of all Klebsiella-like organisms found. Many virulence factors expressed by R.
ornithinolytica were studied in vitro. All isolates produced capsule and expressed CFA/I, and CFA/III.
Nine isolates (81.8%) were able to produce siderophores. Four isolates (36.6%) were able to produce
bacteriocin. All R. ornithinolytica isolates were unable to produce extracellular protease, hemolysin,
and histamine. All isolates of R. ornithinolytica were resistant to penicillin, ampicillin, gentamicin,
chloramphenicol, rifampin, cephalothin, cephotaxime, streptomycin, amoxicillin.,but they showed high
sensitivity to nitrofurantoin and ciprofloxacin, and all them were completely sensitive to meropenem.
R. ornithinolytica expressed a high degree of sensitivity to the effect of human serum when they grew
in human serum at 37 oC for 3 hrs. The present study represented the first record of occurrence of R.
ornithinolytica in human clinical samples in Iraq.

This study investigates the antagonism activity of Lactobacillus acidophilus against the yeast
Candida albicans in vitro. Results revealed that L. acidophilus with high antagonism activity and
inhibited growth of C. albicans. Amodel for oral candidiasis in BALB/c rats was established . After
inoculation with 1×108 C. albicans yeasts, these rats displayed increased levels of oral colonization ,
oral thrush appeared after 4 days of infection . Rats were fed live L. acidophilus for assessing its
capacity to control the oral infection by elimination the yeast from the oral cavity. Data showed that
feeding live L. acidophilus for 15 days significantly shortened the duration of oral colonization
compared to control animals.

25 treated in urology department in al hilla teaching hospital in a period 2004-2007 all of them had
prostatic nodule, all of them send for PSA ,and all of them undergone prostatic biopsy from the
nodule only 15 patients had prostatic carcinoma, 6 patients had BPH, 4 patients had chronic non
specific nodule.
17 patients of all suspicious DRE had PSA more than 10ng/ml, an 5patients had PSA range 4ng/ml
to less than 10ng/ml , and only 3 patients had PSA less than 4ng/ml.
12 patients from a patients with carcinoma of prostate had PSA more than 10ng/ml , tow patients with
prostate carcinoma had PSA (4-10ng/mle), only one patient had PSA less than 4 ng/ml.
So we must recommend combination of PSA and DRE in diagnoses of prostatic carcinoma.

objective: To evaluate the sensitivity and specificity, negative predictive value (NPV), and positive
predictive value (PPV)of ultrasonography (US) in the diagnosis of acute appendicitis.
PATIENTS AND METHODS
A cross sectional study of 125 patients with suspected appendicitis was performed .. The
appendiceal diameter (normal, less than 6 mm), compressibility of the appendix ,intraluminal fluid
and echogenicity of surrounding fat were the primary criteria used to determine the status of the
appendix by ultrasound and compare with histopathological examination as confirmative test
RESULTS:
The prevalence of real confirmed appendicitis by histopathology examination is 46% .while
the sensitivity of sonographic examination in detecting appendicitis is 85%, the specificity is 53%, .
The positive predictive value of sonography is 60 %; while the negative predictive value is
81%.The most accurate appendiceal finding for appendicitis was a diameter of 6 mm or larger 95%
while 81% of confirmed cases have lack compressibility while only 28% of confirmed cases of true
appendicitis have intraluminal fluid .
CONCLUSION:
Sonography is useful in detecting acute appendicitis and can clearly show the abnormal
appendix more frequently .with high sensitivity and low specificity

130 blood samples were obtained from febrile infants who admitted to Babylon Maternity and
Children Hospital during the period from February \ 2008, until June\ 2008. This study investigated
the distribution and the most causative agents (Gram Positive Bacteria), the elevation of (CRP, ESR
and WBCs count) with the infections and antibiotic susceptibility patterns of bacterial pathogens
isolated from patients with bacteremia. Results showed that Staphylococcus aureus formed (57%)
from all bacteremia causative agents followed by Streptococcus pneumoniae (32.3%) and Bacillus
spp. (10.7%).
Staphylococcus aureus showed sensitivity for Amikacin, Nitrofurantoin, Norfloxacin and Ofloxacin,
while Streptococcus pneumoniae were sensitive to Amikacin, Amoxicillin, Cefodizime,
Chloromphenicol, Clarithromycin, Gentamycin, Kanamycin, Lincomycin, Nitrofurantoin,
Norfloxacin, Ofloxacin, Oxacillin, Oxytetracyclin, Penicillin and Rifampim, Bacillus spp. Revealed
sensitivity with Amikacin, Chloromphenicol, Gentamycin, Kanamycin, Nitrofurantoin, Norfloxacin,
Ofloxacin, Piperacillin, Tetracycline, Tobramycin and Vancomycin. From 130 infants with
bacteremia 88 had C-Reactive Protein >24 mg/L, 82 had ESR >35 mm/hour, and 73 had WBC >15
000/mL.

In this study, 100 febrile infants suffering from Urinary tract infection (rectal temperature > 38°C) who
presented to the Pediatric Clinic or Emergency Department of Babylon Maternity and Children Hospital
from February\2008 to June\2008 underwent a history and physical examination. In this study,
Escherichia coli formed the major causative agent (49%) followed by Pseudomonas aeruginosa (25%),
Klebsiella pneumoniae (18%) and Proteus species (8%).
E. coli isolates showed sensitivity to Amikacin, Chloromphenicol, Nitrofurantoin, Ofloxacin,
Norfloxacin, while Pseudomonas aeruginosa shows sensitivity with Norfloxacin, Ofloxacin, Piperacillin,
Tobramycin, Proteus species shows sensitivity with Amikacin, Amoxicillin , Cefodizime, Cefoxitin,
Cephalexin, Gentamycin, , Norfloxacin, Piperacillin, Tobramycin and Klebsiella pneumoniae isolates
shows sensitivity with Amikacin, Norfloxacin, Piperacillin, Tobramycin.
Our investigation showed that from the 100 febrile infants with UTI, 57 had pyuria > 5 WBCs/hpf, 90 had
pyuria >10 WBCs/mL, 77 had CRP >24 mg/L, 82 had ESR >35 mm/hour, and 44 had WBC >15 000/mL.

Phagocytic activity by using nitroblue tetrazolium reduction (NBT) and leukocyte migration inhibitory
factor (LIF) were studied in thirty health persons (20 smokers and 10 in nonsmokers ) .Blood with
anticoagulant were collected from them and used to study NBT and LIF .The results found that there is no
significant differences between smokers and nonsmokers in NBT test . The main of LIf in smokers was
0.528 while in nonsmokers was 0.86 and high significant differences at level P < 0.05.this study found that
smoking effect on specific cellular immune response but no effect on innate immune response .

A prospective study was carried out on 304 cases of bacteremia in newborn less than one year of age
with fever. Cases of gastroenteritis, respiratory tract infections, and suspected sepsis in children seen or
admitted to the Babylon Maternity and Children Hospital in Babylon Province - pediatric wards were
studied from October /2007 to March /2008. Clinical and microbiological data were recorded in a
questionnaire or obtained from patient medical records.
Most of the newborn with bacteremia (78 %) were less than 12 months old. After culturing the blood
samples the results indicated that 240(78%) blood samples revealed positive cultures consisting of 166
(69.2 %) Gram-positive bacteria isolates and 74 (30.8 %) Gram-negative isolates, represented by
Streptococcus pneumoniae consist of 36.7%, Staphylococcus aureus accounted for 18.1%, Viridians
streptococci 14.5%, Staphylococcus epidermidis 13.3%, Streptococcus spp. 7.2%, Bacillus spp. 6% and
Clostridium spp. 4.2% and Gram negative bacteremia causes represented by E. coli 40.5%,
Pseudomonas aeruginosa 20.3%, Salmonella typhi 16.2%, Acinobacter 5.4%, Proteus vulgaris 2.8%,
Haemophilus influenzae 4% and Klebsiella pneumoniae 10.8%, major infections of bacteremia in
Newborns was in age between 1-8 months, consisting of 77%.
The rate of infection in newborns living in rural area was found to be (62.1%) while it was (37.9%) in
urban newborns. The rate of infection with bacteremia in newborns feeding on breast was found to be
(25.4%) while it was (74.6%) in newborn whom artificial feeding newborns.

We have simplified the conventional techniques used to extract DNA from clotted blood by
salting out technique, in such away some simple chemical treatments (SDS and NaCl) of cellular lysate
of clot substituted the hazardous organic solvents such as phenol. Distilled water played an important
role in eliminating almost all RBCs contaminating the specimens. Differences were not identified
between clotted blood procedure and non-clotted blood procedure. Therefore, this method might be
used in routine clinical laboratories for forensic analysis such as finger printing and other
tests.

Idiopathic congenital talipes equinovarus is the most common deformity of the foot.
we report our initial experience in using ponseti method for conservative treatment of club foot .we
studied 42 patients with 62 club feet from July 2002-to-december 2006-in orthopaedic clinic in AlHilla teaching hospital and in private clinic, age from 1st day to 10 months ,by serial correction and
casting (2-8 times, for 7-10 days in each times).tendoachilles tenotomy is used in 6 cases only(with
local or general anesthesia),with follow up after treatment for one year, four patients(6feet were lost
from follow up) . we achieve 82% success rate, failure of correction is mainly related to poor
compliance of the patients to the cast , late presentation of the patient to the orthopaedic clinic, and the
severity of deformity is the third cause. Complications are only 5 cases including, fore foot swelling,
cast slippage and skin necrosis, all complications are treated. We think that ponseti method is a safe
and effective treatment for congenital idiopathic club foot and decreases the need for extensive surgical
correction.

Twenty patients with COPD have been included in this study who were admitted at Mirjan
teaching hospital for Internal medicine, where the disease diagnosed by the physicians according
to the criteria of chronic bronchitis with productive cough in a period of three successive months
in each of two consecutive years in absence of identifiable causes of sputum production with their
age group ranged from 45 up to 86 years at a period from January up to February 2007.
N-acetylcysteine was performed to detect its effect on the growth of twenty bacterial isolates,
90% of these isolates had no growth in the presence of this material, whereas, 10%gave positive
growth even in the presence of this substance.

In this study 128 tap water samples from 14 sites in Babylon hospital for gynecology and
pediatrics being obtained.
The results of bacterial investigations have showed that all water samples are free from any
pathogenic bacteria, however certain bacteria which are considered as contaminants, non harmful
bacteria,were isolated such as Lactobacillus and Micrococcus.Chlorine concetration is detected in all water samples and it was seen that chlorine concentrations were ranged
from (1.2-1.6 ) P.P.M.

One hundred twenty five uropathy patients were with clinically proven persistent pyuria (PP). Bacterial
culture studies for their clean catch midstream urine samples showed that they were of bacterial causes
(BPP). Mucosal and serum globulin concentrations, specific agglutinins and mucosal as well as
peripheral leucocytes inhibition index were made to these patients. Results of these immunologic
investigations have shown, that the associated bacterial uropathogens (ABUs) were of both gram
negative and gram positive types. These ABUs may have one or more than one of the antigenic
epitopes. The patient immune responses were dependent on the nature of the immunodominant epitope
of the antigen. Thus antibody responses may be scored alone or antibody and cell mediated responses
can be scored among these patients. Immunocompromy, no matter of its origin reduce the outcome of
the immune function . Five immunoprofiles were deduced as;
Profile I: The infection stimulate mucosal and systemic humoral and cellular immune responses.
Profile II: The infection stimulate mucosal and systemic humoral immune rcsponses.
Profile III: The infection stimulate reduced mucosal and systemic humoral and cellular immune
respones.
Profile IV: The infection stimulate low grade mucosal and systemic humoral immune responses.
Profile V: The aetiogen nonrecoverable with low globulin levels.

This study deals with the host resistance to infection in diabetes and the influence of an acute
infection on the endocrinologic- metabolic status of the diabetic patient, while it is well known that
acute infection lead to defecting in controlling blood sugar levels and that infection is the most
frequently documented cause of ketoacidosis. The patient with diabetes mellitus are more susceptible
to infection than age and sex matched non diabetic subject “the data were being studied as phagocytic
activity or (leucocytes function) to ingest bacteria (This study consist of 72 diabetic patients and 19
apparently healthy individuals. These samples in this study have been grouped according to the severity
of diabetes, duration of disease , insulin non insulin dependant, controlled and noncontrolled for all
patient and control sample. Phagocytic activity is done as well as bacterial cells per neutrophil and rate
of ingestion of phagocytic cells to the bacteria among time of incubation).
The result among 72 diabetic patients showed a highly significant decreased(P<0.01) in phagocytic
activity of neutrophil among this patients and direct correlation between the phagocytic activity of
polymorphonucleur neutrophil (PMN) (P< 0.05) and the mean glucose level after comparsim with the
control samples. The effect of duration of disease give a highly significant differences (P< 0.01) with the
phagocytic activity after comparism with control group as well as less than 5 years and more than 5
years. There is a significant diminution in phagocytosis of staphylococcus aureus in subject poorly
controlled diabetes in comparism with the control group. The result from these study suggest that good
control of blood sugar in diabetic patient is a desirable goal in the prevention of continuous infection
(Bacterial, Viral, Fungal....etc) and to ensure maintenance of normal host defense mechanism that
determine resistant and response to such infections.

In the present study, 173 children stool specimens less than 12 months of age suffering from diarrhea
collected in suitable clean containers and examined firstly macroscopically and then microscopically
from Babylon hospital for children and maternity from January/2008 to May/2008. Presenting acute
diarrhea was examined to identify associated parasitic Enteropathogens agents. Parasitic causes formed
(56%) from all cases represented by; Entamoeba histolytica 41.2%, Ascaris lumbericoides 32%,
Giardia lamblia 18.6%, Trichuris trichura 6.2% and Hymenolepis nana 2%. Parasitic infections in
rural newborn revealed (68%) higher than urban cases (31.9%), Parasitic infections with breast feeding
are less infected than whom artificial depending feeding (42.2%) and (57.7%) respectively. Most
parasitic infection like Entamoeba histolytica, Ascaris lumbericoides, Giardia lamblia and Trichuris
trichura was higher in patients aged from (9-12 months) formed 70%, 64.5%, 55.5% and 100%
respectively.

In the present study the aim was to determine whether there is an association between H. pylori infection
and IHD or not , which was demonstrated in Hilla province patients, thirty male patients admitted to
c.c.u. complaining of acute MI Their Age range ( 35 – 45 ) was estimated for anti H. pylori antibodies in
their sera with thirty healthy persons as control .
The study revealed that twenty one patients with acute MI shows positive test for anti H. pylori
antibodies while only nine of them shows negative test, using a chi square statistical method we found a
significant association of H.pylori infection with IHD ( P<0.05), in relation to control.
The sensitivity of the test in general 70 % while the specificity is 30 % , using percentage and according
to the type of MI , ant MI shows the highest percentage (50%) while the lat. MI shows the lowest
percentage (3.3%).suspect to idea of possible relation of site of myocardial infarction with H. pylori
infection.

Many studies had been established to detect the affects presence of leucocytes on semen quality and
sperm function tests . Than after their effects on men fecundity.
This study had been occure on infertile (48) asthenozoospermic , (18) oligozoospermic & (13)
azoospermic patients as well as to (10) control subjects .
Results study of this work obvious that presence of leucocytes in seminal fluid can be explained as :
1-Inflammatory response .
2- Nonspecific cellular immune response .
3- Cooperation and / or inverse cooperation of natural and adaptive
Immune responses to foreign antigenic epitopes.

Bach ground:-The optimizing of postoperative pain control is an important aspect in perioperative patient
care the use of inscional local anaesthesia in post operative pain control after abdominal operations was
proved effective method of analgesia
Aim:-to evaluate the efficacy of postoperative incisional infusion of local anaesthesia (bupivicain) in
reduction of postoperative pain in abdominal surgical wounds as well as the need for systemic analgesia
and possible side effects of local anaesthesia. Patients and
method:- aprospective randomized placebo controlled clinical trial on 80 patients (39 male 41 female)
between 13 –54 years old of different abdominal operations, admitted to El- furat hospital in kufa city from
December 2005 to October 2006.The patients were divided in tow groups, intervention group 40 patients
and placebo group: 40 patients. The study involve the use of incisional intermittent injection of local
anesthesia bupivacaine 0.25% via thin subfascial catheter ( B/BRAUN Melsungen AG), in
intervention group , for relieve of postoperative pain and assess need for systemic analgesia ( especially
opiate) as compared to placebo group in which we inject normal saline via the incisional catheter.
Result:-The study had been discusses age, sex distribution, types of incision, pain assessment by visual
analogue score, the need for systemic analgesia & complications of local anesthesia.
The mean visual analogue score of pain was measured in 1st 6th, 12th , 18th , 24th hours after
surgery in every patient in both groups were significantly decreased in bupivacaine group in comparism to
normal saline group P<0.005.
There is significant decrease for systemic analgesia requirements after operation in intervention
group as compared with placebo group (P<0.05).
There is only one minor complication (seroma or wound infection) was reported in each group
(2.5%).
Conculsion:-Study concludes the effectiveness of incisional bupivacaine intermittent injection in relieve of
postoperative pain and decrease need for systemic analgesia.

Sixty male patients were studied with age 18-72 years (mean age 42 years), there weight 55-80 kg
(mean 72 kg) in Basrah military hospital(2001--2002) The patients were allocated to receive either
0.5% bupivacaine or none.
• Group A(20 patients) underwent either the renal or bladder surgery with no bupivacaine receive.
While the other 40 patients selected and enrolled in 2 groups(B and C) according to the site of the
wound as following:
• Group B(20 patients) with renal surgery .
• Group C ( 20 patients) either bladder surgery or transvesical prstatectomy.
Both B and C are allocated to receive bupivacaine.
The results revealed there is a significant difference of the pain score between group A(7.65+/- 1.56)
(not receive) and those received bupivacaine groups BandC,which are 1.25+/-0.2 in group B, and
0.6+/-0.13 in group C of pain score of 10 cm.Thus, wound instillation with bupivacaine should be
regarded for routine usage.

Background: Increased concentrations of plasma total homocysteine and decreased concentrations of
plasma selenium are separately associated with cardiovascular disease.
Objective: Investigate the correlation between plasma total homocysteine and selenium in patients with
acute myocardial infarction (AMI).
Methods: Patients of present study was thirty nine men with AMI admitted to Marburg Hospital in
Marburg city, Germany on 2007. Plasma total homocysteine was determined using HPLC. Plasma
selenium was determined using atomic absorption spectrometry.
Results: Plasma homocysteine of patients found to be increased, whereas plasma selenium found to be
decreased when compared with reference range . The correlation between plasma homocysteine and
selenium found to be negatively correlated.
Conclusion: The negative correlation between plasma tHcy and selenium may indicate that they have a
significant impact on the process of atherogenesis. The change in the levels of plasma total homocysteine
and plasma selenium might be result from oxidative stress associated with AMI.

Thromboembolic events are common cause of death in patients with myeloproliferative disorders
(MPD) especially those with cardiac involvement . In previous studies, cardiac involvement,
including coronary arterial thrombosis, myocardial infarction, pulmonary hypertension (PHT),
asymptomatic pericardial effusion, cardiac tamponade, intractable cardiac failure due to
intraventricular thrombosis, and stenosis of aortic, mitral valves, even requiring surgical
treatment had been reported in MPD
This cohort study was carried out in three Iraqi teaching hospitals for Medicine including AlKadhimyya Teachginmg Hospital , Al-Yarmook Teaching Hospital (including National
haematology Centre) and Merjan Teaching hospital in Babylon. The study groups were 26
patients (mean age female and male) with MPD and 30 age-matched healthy controls. MPD
group included sixteen cases chronic phase chronic myelogenous leukemia (CML), two
idiopathic myelofibrosis (MF) , seven polcythemia vera and one essential thrombocythemia .
History regarding thrombotic and bleeding complications, examination and lab investigations are
evaluated for these patients and transthoracic echocardiographic study was done for them and for
the control subjects. The results are compared by statistical methods.
Mitral regurgitations were present in 9 patients (34.6%) and two controls (6.7%) (P < 0.05).
Aortic regurgitation were present in 3 patients (11.5%) and no control (0.00%) (p < 0.05%) .
Rates of regurgitations of other valves were not different in-between MPD subgroups and control
(P>0.05). The rates of annular calcifications and valvular thickening were not different between
MPD and control groups. Pulmonary hypertension (PHT) was not detected in patients or control.
Measurements of ejection fraction, fractional shortening of left ventricle, E/A ratio and aortic
root dimension are significantly different between MPD and control (P<0.05). Left atrial
dimension of patients with MPD was larger than controls (P>0.05). Left atrial dimension was thelargest in PV (P<0.005). End-diastolic diameter of left ventricle , opening of aortic valve and left
atrial dimension were larger in patients with thromboembolic events than patients without
thromboembolic events (P<0.05). Measurements of ejection fraction and fractional shortening of
left ventricle were lower in MPD groups than control (P<0.05 and <0.005) respectively. The rates
of all other echocardiographic parameters were not significantly different related to existence of
thromboembolic events (P>0.05).
This study showed that valvular lesions were more prevalent in MPD. Erythrocytosis was more
important than thrombocytosis in relation to cardiac parameters which related to thromboembolic
events. Further evaluation of the cardiac changes in MPD subgroups with extended studies
including trans-oesophageal echocardiography, right-heart catheterization and longer follow-up
periods would be appropriate.