Medical Journal of Babylon

Objective: The aim of this study is to assess the incidence of variable causes of pancytopenia in Babylon
governorate,Iraq and to determine their relation to age, sex, clinical manifestations and disease outcome.
Materials and Methods: This is a prospective and descriptive study of 74 patients representing all
patients with pancytopenia admitted to or attending Marjan Teaching Hospital, Al-Hilla Teaching
Hospital, or Babylon Hospital for Paediatrics in Babylon,Iraq during the period from 1st July 2007 to 31st
September 2008.
The patients who were on chemotherapy for any reason or had a previous diagnosis for the cause of
pancytopenia were excluded.
Results: The most common causes of pancytopenia were acute leukaemia and a plastic anaemia
constituting more than 56% of patients, followed by kala azar in 10.8% and hypersplenism in 8.1%.
Other causes found in this study include lymphoma, multiple myeloma and megaloblastic anaemia in
5.4% of patients for each; hairy cell leukaemia and secondary metastasis to bone marrow in 2.7% for
each; myelofibrosis and myelodysplastic syndrome in 1.3% for each.
Fatigue and fever were the most common symptoms seen, while pallor and splenomegaly were the
most common physical findings.
Conclusion: Acute leukaemia was the most common cause of pancytopenia, followed by aplastic
anaemia and kala azar.

Background: About [ 20%-25%] of type 2 diabetes patients are unresponsive to sulphonylureas (primary
failure) and an additional 5%-10% of patients each year become unresponsive (secondary failure).
Objective: Assessment of the efficacy of repaglinide in the treatment of secondary sulphonylurea failure.
Patients and Method: 48 patients with type 2 DM who failed to respond to a combination of full dose of
glibenclamide and metformin are put on combination of repaglinide (3mg/day) and metformin and blood
glucose is monitored for 9-11 weeks.
Results: 12 patients [25%] out of 48 patients with secondary sulphonylureas failure obtained good
glycemic control with repaglinide.
Conclusion: Repaglinide can induce good glycemic control in some patients with secondary
sulphonylureas failure.

Background: Diabetes mellitus is a common metabolic disorder with significant impact on morbidity and
mortality. The various diabetic complications including GI dysfunction have been widely studied and
documented.
Objective: To assess the prevalence of GI symptoms in diabetic patients in Al-Najaf city.
Methods: A prospective case controlled questionnaire-based study surveys the prevalence of symptoms
of GI dysfunction in 100 diabetic patients and 70 non-diabetic subjects.
Results: The prevalence of GI symptoms in the diabetic and control subjects was 40% and 12%
respectively. The common symptoms were constipation, belching, epigastric pain and diarrhea.
Conclusion: The prevalence of GI symptoms is higher in diabetics than control.
Poor control and longer duration of DM are associated with significant increase in the prevalence of GI
symptoms in diabetic patients.

Objectives: (a) To determine the effect of regular desferroxamine (DFO) therapy on De-Ritis ratio. (b)
To determine the changes in some liver function test parameters between patient on regular DFO and
those with irregular DFO therapy.(c)To determine the relation between serum iron and serum ferritin in
both groups. (d) To determine the effects of age, sex and body mass index (BMI) on measured
parameters in both groups.
Subjects and Methods: This study was conducted at Thalassemia Center /Ibn-Al-Atheer Pediatric
Hospital in Mosul from October 2007 to April 2008. Forty patients with β- Thalassemia were selected
as follow: twenty patients with regular DFO therapy and other twenty with irregular DFO therapy.
Results: De-Ritis ratio serum Ferritin, Ferritin: total serum protein ratio and total serum protein show
no significant changes between both groups. Serum ALT, AST, ALP activities and serum iron show a
significant increase in those with irregular DFO therapy [P < 0.01].
Conclusion: Irregular DFO therapy shows significant effects on serum iron and some other liver
function test parameters that indicate chronic hepatocytes damage without changes in De-Ritis ratio
which is used as an indicator for acute hepatocytes damage.

This study was done to determine the seroprevalence of Toxocara infection in children by using
ELISA test.
Blood samples were collected from 120 hospitalized children with age ranging from [1-15]
years, and [25] children (apparently healthy) served as controls.
Serum samples of 120 children [66 males and 54 females] and 25 healthy controls were examined
for anti-Toxocara IgG antibody by a commercial ELISA test. The seropositivity rates were 30.8% and
12% in diseased and healthy children respectively. No statistical differences were observed with regard
to age and sex. Diagnosis of sera from children with geophagia in urban and rural areas revealed that
55.2% were seropositive for Toxocara IgG antibody. Haematological parameters in children showed
that the highest ESR rate and lowest Hb% was frequent in 1-2 and 3-5 years old respectively.
Eosinphilia was statistically frequent in 3-5 year old group.
Conclusion
Toxocara seroprevalence suggest that toxocariasis is frequent in children in this community.

In this study, 38 lean individuals (normal weight) and 27 obese individuals (over weight) were chosen
randomly to show the activity of 5'- nucleotidase in the sera of those individuals.
Body mass index (BMI) was estimated to determine the lean and obese individuals. It was seen that the
enzyme activity was increased in obese individuals particularly in those whose their BMI was higher than 30
kg/m2. Also , it was found that enzyme activity also increased in the obese individuals whose their age group
was above 50 years old.

This thesis is a retrospective study of 270 patients with carcinoma of larynx admitted from January 2, 1991
to May 31, 1995 in E.N.T. - Head and Neck Surgery Center in Medical City in Baghdad. The age ranging
between 5th – 8th decades with peak incidence in the 7th decade in males and 6th decade in females.
77.4% were males and 23.4% were females and male: Female ratio was 3.3:1. The majority of the
patients presented with hoarseness. Supraglottic carcinoma was the commonest region.
The incidence of lymph node metastases was 23.5% and it was highest in transglottic carcinoma
followed by supraglottic carcinoma.
Stage T1N0M0 was more common than other stages and radiotherapy was the mainstay of
treatment of our patients.

This is a review including the wheezing diseases in children, who hare attended the Outpatient Department
and Emergency Department in the Maternity and Children Teaching hospital in Al-Diwaniyah, from
1/1/2006 to 31/12/2006.
Our study shows that the total number of patients. attending the Outpatient Department tare more than the
number of patients. in the Emergency Department and this is possibly due to the fact that a large number of
them are mild cases and not required admission to the. emergency department
Our study shows an increasing percentage of wheezing in children in winter seasons particularly January,
February , due to increase incidence of acute respiratory diseases in these months.
There are two peaks of number of patients. who are admitted to the Emergency Department for different age
groups, first peak on January , and the second peak on October and this is due to increase incidence of acute
respiratory disease.

A total of 49 patients were included in this study, 29 patients with oral benign and malignant
lesions, and 20 healthy individuals were included as control.
All these cases were examined by using cytobrush technique.
The study aimed to evaluate the sensitivity and specificity of cytobrush method in the detection of
precancerous and cancerous lesions of oral mucosa.
The results of cytobrush method were compared with those of scalpel biopsy of suspicious oral lesions.
The brush method has high sensitivity and specificity rate (88% sensitivity, 100% specificity). The
cytobrush method was a highly accurate method of detecting oral precancerous andcancerous lesions (93%
accuracy rate).
Although the histological pattern was the definitive diagnosis in those patients, but when the lesion was
doubtful, the cytological examination (cytobrush technique) was not only supportive but also diagnostic. It
can aid in confirming the nature of apparently benign oral lesionsand, more significantly, revealing those
that are precancerous and cancerous when they are not clinically suspected of being so.
All cytobrush positive results should be referred for scalpel biopsy and histology to completely characterize
the lesion.

The aim of this study is clinical and pathological evaluation. of nodular thyroid Goiter Patients.
Methods :- The Present prospective study pts of nodule thyroid goiter who were treated surgically was
performed over a period from February 2004 – January 2007. clinical symptoms and signs, thyroid
function test and Formalin fixed , Paraffin embedded blocks from 127 patients with thyroidctomy were
included in this study.
Results : - A total of 127 cases were included there is female predominance (77%), (73.1 %) cases were
euthyriod, (24.2 %) cases hyperthyriedism and (3.1 %) hypothyriedism. the histopathological results of
thyroid Nodules were ( 69.3 %) colloid nodular Goiter, (15.7%) toxic Nodules, 11.8 % thyroid tumors only
(3.2 %) was hashiomito's thyrioditis. The Papillary carcinoma is the most common malignant tumor (3
cases) followed by follicular carcinoma (2 cases).
Conclusion :-
Based upon the findings of this study. It can be concluded that Most of thyroid nodules are benign ,
Euthyriod and more common in female. Most cases of hypothyroidism associated with hashiomates
thyrioditis. Papillary carcinoma is Most common Malignant thyroid Nodule tumor. benign thyroid tumor is
more common than Malignant thyroid tumor. Incidental finding of thyroid tumor was in majority of cases
of thyroid Nodule while the Minority of cases were clinically suspicious

The study included (150) patients with benign prostatic hyperplasia and or chronic prostatitis who
referred Al-Hilla Teaching Hospital-Department of Urology, from (October) 2004 to (May) 2005.
. Patients age ranged from (30-99) years with mean age of (63.9) years. It was found that (78%) of them had
benign prostatic hyperplasia 13.3% had chronic prostatitis and 8.7% had benign prostatic hyperplasia and
chronic prostatitis.
The clinical features were frequency (98%), nocturia (90%), urgency (82%), hesitancy (53%), dysuria
(51.3%), poor stream (46.7%), dribbling of urine (22%). Other clinical features were pain (22%) such as
supra pubic pain, lower backache, groin and perineal pain.
About (20.7%) of patients had post voiding residual urine, while (10%) had history of catheterization and
cystoscopy was done to (4%).
Results of general urine examination were pyuria (54%), red blood cells (20.7%), bacteruria (8%) and
(12%) had sterile pyuria with urine culture and sensitivity negative.
Regarding the results of urine cultures in patients with benign prostatic hyperplasia and or chronic
prostatitis, (43.3%) had positive culture for bacteria. E.coli was the most common type of bacterial isolates
(14.7%), Staphylococcus epidermidis (6%), Klebsiella pneumoniae and Staphylococcus aureus ,each of
which represented (4%), Acinetobacter spp. (3.3%), Enterobacter spp. and Pseudomonas aeruginosa
represented (2.7%)for each, Proteus mirabilis (2%).

Clinical data of involve 554 healthy children, with traumatized permanent anterior teeth fracture in this
children who were treated in to Hilla Specific Dental Clinic during school time, were collected. The type,
reason, and mode of the trauma, the number of teeth involved in each person and time elapsed before
treatments were analyzed. The results suggested that boys were more susceptible to traumatic injury of
anterior teeth, and the highest prevalence of dental trauma was determined in the 8 years age group and
higher than boys in the 10 years age girls group type score 3(Coronal enamel and dentine fracture without
pulp exposure) and the result show that boys with 8-9 years age were more susceptible to traumatic injury
score 4 type (Fracture from Coronal enamel and dentine involve expose pulp area) was the most common
type. Most children went to hospital in 2 to 24 hours after injury. Falls was the most common reason.

Background: TNF-α is one of the cytokines produced by the immune system. Many studies have been done
to investigate the role of the immune system in first trimester pregnancy loss.
Objective: To evaluate the association of TNF-α with recurrent and missed miscarriage.
Method: a case-control study involved 35 women, 15 with recurrent miscarriage (at least three consecutive
spontaneous abortions) , 10 with missed miscarriage and 10 with normal first trimester pregnancy (control
group). The study was conducted from the 1st of January to 30th of June 2008. Blood samples were taken
from these women, TNF-α was measured in the sera by an immunoenzymometric assay using Biosource
TNF-α EASIA kit (Biosource Europe S.A.).
Results: student t-test was applied to analyze the difference in serum TNF-α level between the groups. The
level of significance was defined at P value < 0.05. Significantly higher levels of TNF-α was found in
women with recurrent miscarriage as compared to control group (68.94 pg/ ml versus 27.40 pg/ml). The
difference was also significant when comparing women with missed miscarriage with the control group
(54.39 pg/ml versus 27.40 pg/ml). The level of TNF-α was higher in women with recurrent miscarriage
compared to women with missed miscarriage, however the difference between them was not statistically
significant.
Conclusion: TNF-α has a significant association with miscarriage, the level is significantly higher in
patients with recurrent and missed miscarriage compared to normal pregnant women; the level is higher in
those with recurrent miscarriage when compared to patients with missed miscarriage.

The problem of AIDS is being increasingly recognized in the Middle East, and as the disease is
fatal and incurable it is important to spread health education messages about prevention and control of the
disease which depends mainly on knowledge of mode of transmission of the infectious agent and how to
prevent it.
Aim: This study aims to identify the level of college students' knowledge and attitudes about the disease
and to find out some of their beliefs about it.
Methods: this is a cross sectional survey conducted in Baghdad and Mousel among College students as a
representative of the educated young adult, males and females. The study sample included 594 students
from the 2nd, third and 4th year. Questions included knowledge about transmission of the disease, and the
way to prevent its occurrence, and their beliefs about the most risky group to be infected with that disease
and what is their attitude towards infected people.
Results: rate for correct response on 70% of questions about knowledge of mode of transmission of the
disease was 42.4%. Knowledge of transmission by shared drug injection was 83.3%, by blood 94.4% and by
sex 97.3%. As for prevention, 48.5% answered correctly for more than 75% of questions. 97.6% knew that
it is prevented by avoiding illegitimate sex, 97.1% said by examination of donated blood and 92.4% said by
using disposable syringes. The students believed that the risky group to be infected is women of infected
person (82.8%), men who have illegitimate sex (94.9%) and medical and health personnel (62.9%). As for
the attitude towards infected people 71.5% of respondents accepted within the community without being
isolated in especial places. The source of the students' knowledge was from TV and private readings.
Key words: Knowledge, students, college

Aim: to determine epidemiological characteristic of all cases of AIDS that were still alive up to the 31st of
Dec. 2002 and compare them with the newly diagnosed cases during the year 2004.
Patients and methods: the study was carried out in health centers that perform HIV test, and the
communicable disease control center in Baghdad. The study was conducted during the year 2005 and a
cross-sectional design was adopted. Demographic characteristic of patients were documented as well as the
source of their infection.
Results showed that 77% of newly diagnosed cases during the year 2004-2005 were of age group 20-39
years and males constituted 84.6% of cases, and they had acquired the disease from abroad or by blood
transfusion. The highest rate of cases that were still alive up to the 31st of Dec. 2003 was in age group 2039 also, the rate of males was 68%, and 58.3% of them had acquired the disease by blood transfusion.
Conclusion: AIDS is highest among young adult males, and the disease is acquired by blood transfusion or
imported from abroad. The difference between the newly diagnosed cases of 2004-2005 and those pooled
up until the 31 of Dec. 2002 was that there were cases of younger age group and the disease was acquired
by parenteral route mainly.

Aim of study:Was to determine wheather metformin , which reduces hyperinsulinemia , would reverse
the endocrinopathy of PCOS, allowing resumption of regular , normal menses.
Subjects and Methods:A study included 29 patients with PCOS were treated with metformin for 3-6
months and effects on regulation of menstrual cycles, weight reduction, improvement in
endocrinopathy was assessed after treatment.
Results: Of 29 patients with PCOS,with menstual irregulation, the analysis showed that 20 patients
resume normal menses after metformin therapy, 14 patients loss weight , and there was reduction in
level of blood insulin and testosterone after treatment .
Conclusion: Safe and effective therapy with metformin in PCOS reverses endocrinopathy , restores
normal menstrual cycles , and restores fertility, allowing pregnancy.

The present study was designed to investigate changes occurring in hematological, and biochemical
changes in patients suffering from hyperthyroidism. A total number used was 170, patients and healthy
subjects of both sexes, males and females. The total number of patients was 130; 100 females and 30
males, while the number of control subjects was 40. The ages of all subjects ranged between 20 years
to 55 years. It was also found that percentage of affected females (76.93%) more than that of affected
males (23.07%).
Concerning haematological changes, studying red blood corpuscles count (RBCs), hemoglobin
concentration (Hb) ,and packed cell volume (PCV) showed a significant increase (P<0.01) when
compared with healthy subjects. In addition, values of hemoglobin electrophoresis which included
adult hemoglobin (HbA), adult hemoglobin2 (HbA2),and fetal hemoglobin (HbF) showed non
significant difference when compared with control subjects. Results of erythrocyte sedimentation rate
(ESR) and white blood cells count (WBCs) were also recorded non significant difference in a
comparison with those healthy subjects.
Biochemical changes in serum, total serum protein (TSP)and serum albumin levels pointed out
significant decrease (P<0.01) in hyperthyroid subjects, while serum globulin values showed non
significant decrease when compared with those control subjects. More over, the present study was also
involved determination of sodium (Na+) and potassium (K+) levels in both serum and urine samples of
hyperthyroid patients. Sodium values showed significant increase (P<0.01) in both serum and urine
samples. While , results of potassium showed non significant decrease in both serum and urine samples
of hyperthyroid subjects when compared with control subjects. Total serum cholesterol levels showed
significant decrease (P<0.01) in comparison with control subjects. In addition, results of serum
triglycerides showed significant decrease (P<0.01) when compared with those healthy subjects . In
view of the changes summarized, the increase or decrease in some hematological and biochemical
parameters may be attributed to hyper metabolic state which arise due to higher production of thyroid
hormones which, in turn, affect most of body tissues.

Introduction :Amniotic fluid volume is an important parameter in the assessment of fetalwellbeing. Oligohydromnios occurs in many high risk conditions and is associated with poor perinatal
outcome. Many caregivers practice planned delivery by induction of labor or caesarean section after
diagnosis of decreased amniotic fluid at term by an ultrsound.Decreased amniotic fluid volume is
correlated with increased peripartum morbidity and mortality. Many ultrasonic methods are used to
evaluate the amniotic fluid adequacy but which of these are the best, the current study will evaluate
the different methods available and are commonly used in clinical practice.
Objective:1.To compare the use of the amniotic fluid index with the single deepest vertical pocket
measurement as a screening tool for decreased amniotic fluid volume .
2.Show the relation of that screening tool for evaluating oligohydromnios to common obstetric
intervention used to terminate the pregnancy.
3.Study the effects of that method of assessing oligohydromnios , obstetric intervention on the
neonatal outcome.
Materials and methods:300 pregnant women attending Babylon maternity teaching hospital ( both
out-patient and in- patient )from 2002 -2006, they were visiting the ultrasound department of that
hospital after 34 weeks of their pregnancy for antepartum assessment of fetal well-being, a diagnosis of
oligohydromnios was made by the ultrasonographer using 2 methods for evaluation, the deep
amniotic fluid pocket <2cm x 1cm or amniotic fluid index=or< 5cm,then following the patients till
labor was induced, or the women had cesarean section for fetal distress, neonatal outcome was
followed also.
Results:
1.When the amniotic fluid index was used ,significantly more cases of oligohydromnios were
diagnosed and more women had induction of labor ,60 % versus 15% in those with the diagnosis of
oligohydromnios made by deep amniotic fluid pocket,P- value was 0.001.
2.Women with oligohydromnios diagnosed withAFI <5cm were more likely to undergo cesarean
section delivery for fetal intolerance of labour(25% versus 10,% in those with deep pocket ),p-value
was 0.014.
3.There was no difference between the 2 groups for neonatal outcome, including : admission to a
neonatal intensive care unit, birth weight, the prescence of meconium, an Apgar score of less than 7 at
five minutes.
Conclusion: The present study shows that single deepest vertical measurement in the assessment of
amniotic fluid volume during fetal surveillance seems abetter choice since the use of the amniotic
fluid index increases the rate of diagnosis of oligohydromnios without improvement in peripartum
outcome.

The present investigation was conducted to evaluate the effect of calculi weight and the frequency of
calculi formation in their compositions. The present investigation was conducted to evaluate the
urinary calculi compositions quantitatively. Fifty-two calculi were obtained from 38 males and 14
females afflicted with urolithaisis, The calculi were subjected to qualitative analysis, and sought for
calcium, uric acid, phosphorus, oxalate, magnesium and ammonium ion contents. Small calculi were
demonstrated to be rich in calcium oxalate, while large calculi were rich in calcium phosphate. The
frequency of calculi formation was demonstrated to influence the calculi compositions. Thus, calculi of
non-stone formers were exhibited to be rich in calcium oxalate, while those of stone formers were rich
in uric acid.

A prospective study was conducted on 129 patients with thalassemia, classified as 67 patients with
β- thalassemia major, 52 patients β-thalassemia intermedia and 10 patients with sickle cell thalassemia,
who were attending the thalassemia center at Babylon Maternity and Children teaching Hospital, from
period of July 2008 to April 2009, their age ranged from 6 months – 26 years with mean age of 10.9
years. They were studied for diabetes and hypocalcemia. Four patients (3.1%) have diabetes and 28
patients (21.7%) have hypocalcemia with a mean level of serum calcium 1.61 ± 0.23 mmol/L in
comparison to control group where they have 0 % diabetes and 10 patients (10%) hypocalcemia with
mean level of serum calcium 1.9 ± 0.16 mmol/L.
Risk factors for diabetes are age older than 15 years, frequent blood transfusion of more than 200 units
and S. ferritin of more than 2000 μg/L. While, in hypocalcemia, the risk factors are age older than 5
years, blood transfusion of more than 50 unit and S. ferritin of more than 1000 μg/L.
Also the study showed that diabetic patients associated with 100% short statures, 75% (hepatitis,
heart failure, and delay sexual development) and 25% hypothyroidism. While in hypocalcemic patients
associated with 75% short stature , 50% delay sexual development, 32.2% heart failure,
21.4%hepatitis, and 17.8% hypothyroidism .

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.

Surgical treatment of gallstone disease has changed dramatically because of the introduction of laparoscopic
cholecystectomy that is why The rapid and widespread adoption of laparoscopic cholecystectomy has
aroused concern about the safety of the new procedure. this analytic study was conducted in Al-karama
general hospital ,kut city,on 100 patients with symtomatic gallstones over 2years. 99% of patients were
Iraqi citizens and only 1% was a palastinian. 75%were from Wasit,22%from Nassirya and 3%from
Baghdad governorates.the vast majority were females(87.4%) ,the mean age was 39.9year with a range
from14-70year .the patients underwent laparoscopic cholecystectomy after complete preoperative
assessment with a success rate of 94% ,while 6%of patient completed by conversion into open laparotomy.
the mean operative time was 36.2 minutes ,ranged from(180-15)min. the mean hospital stay was 1.43 day,
ranged from (1-18)days. there was no major complications and the intraoperative complications were
managed intraoperatively. no death was encountered in this series . the mean time to return to work
was12days.This study showed that laparoscopic cholecystectomy is a safe procedure with short operative
time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality
rate.

Behcet’s disease is a vasculitis of unknown etiology, it is most prevalent in Mediterranean area, the
most serious problem is ocular involvement, and with the use of the immunosuppressive agents, ocular
prognosis had significantly improved.
The interferon 2 is a biological agent used for the treatment of viral hepatitis and renal cell
carcinoma. It is used now for the treatment of Behcet’s disease, the mode of action of INF in Behcet’s
disease is still unknown, it has many immuno -modulatory effects, such as enhancement of HLA class (I)
antigen expression on the lymphoid cells, T and NK cell cyto-toxicity, and it diverts the T cell response.
Forty patients had been studied through (2006 - 2008) in Merjan Teaching Hospital to compare
the use of interferon 2 versus other immunosuppressive agents to show the difference especially in
refractory eye problems and vascular involvement.
Six to nine million units of interferon per week were given subcutaneously to (20) patients whom
either newly diagnosed or already had Behcet’s disease and did not respond to other immunosuppressive
agents , those patients are compared with other (20) patients whom already treated by other drugs like
cyclosporine, azothioprine and other immunosuppressive agents .
The duration of the treatment with interferon was (3-6) months and ophthalmologist and
rheumatologist did follow up for one year.
The mean age of the patients was (14-55) year, the group one included (14) males and (6) females
while group two included (13) males and (7) females.
The group one showed dramatic response to interferon, especially among the newly diagnosed
patients while those patients treated with other drugs got better response with the use of interferon alone.
Only three patients not responded to interferon, one was newly diagnosed and the other two were
already diagnosed.
Thirteen patients showed complete remission or became stable during follow up period.
While in group two, (8) patients showed relapse after stopping therapy, (2) patients showed
deterioration of the visual acuity and eye problems even with therapy and (10) patients showed complete
remission in the follow up period
From this study, we found that interferon 2 is the newly emerged therapy of Behcet’s disease and
its complications that are not responding to ordinary therapy.
Interferon2 is useful in the treatment of Behcet’s disease in Iraq and should be used to prevent
serious problems of the disease like blindness and vascular obstruction.

Recently, progress has been made to utilize the matrix metalloproteinase inhibitory properties of
some drugs for developing anti-inflammatory drugs that are efficacious and relatively free of side
effects, and can be used effectively for a long time. The present study was designed to evaluate the
dose-response relationship of the anti-inflammatory activity of doxycycline in experimental animal
models of chronic inflammation and compared to that produced by the standard drugs dexamethazone
and methotrexate. Seventy two rats were allocated into nine groups, each containing 8 rats, for the
study of the anti-inflammatory activity of doxycycline in experimental animal model of formaldehydeinduced chronic inflammation; another 16 rats were used, and allocated into two groups, each
containing 8 rats, for the study of the anti-inflammatory activity of (doxycycline 2.5 mg/kg) when used
in combination with dexamethasone or methotrexate. The result of the present study reported that
doxycycline in the dose range of (0.1, 0.2. 0.4, 0.6, 1.2, 2.5 mg/kg) significantly suppress
inflammation in experimental animal model of formaldehyde induced chronic inflammation.
Combination of doxycycline with dexamethasone (1 mg/kg body weight) significantly suppresses
inflammation which was higher than all of the effects produced by other approaches of treatment. In
conclusion, doxycycline, in a dose dependent pattern, was effective in attenuating formaldehydeinduced chronic inflammation in rats and has the ability to potentiate the anti-inflammatory activity of
dexamethasone and methotrexate.
Runing title: Anti-inflammatory activity of doxycycline
* Corresponding author address: Dr Saad A. Hussain (PhD), Department of Pharmacology and
Toxicology, College of Pharmacy, University of Baghdad; E-mail: saad_alzaidi@yahoo.com

The patella form patellofemoral joint . this joint is a complex articulations with high
functional and biomechanical requirements. Multiple clinical problems of the knee
joint may caused by anatomical and physiological abnormalities of this joint. So exact
knowledge about the anatomy , the biomechanical and function of patellofemoral joint
is there fore required to understand its wide rang of pathology. so 10 patella of adult
human where measured the surface area of medial and lateral articular surfaces. The
result indicated that lateral articular surface area of patella is larger than medial one.
This lead to conclusion that there is increase pathological regions on the lateral side of
the knee joint, beside increasing contact area in human weight bearing and cause pain
on the lateral side with increasing contact area during flexion exercise of the knee
joint.

Objective :To evaluate the effects of vaginal progesterone in reducing the risk of preterm delivery in
women with short cervix.
Setting :Dept. of Obstet. and Gyncol.,Babylon Maternity Hospital , Ultrasound unit, 2008-2009
Materials and methods: Prospective Follow up study carried for 2 years, cervical length was measured
by vaginal ultrasound in 313 women with history of preterm delivery( one or subsequent type),46
women with cervical length of < 28mm was evaluated further and divided in 2 group, study group
which include19 pregnant women received 200Mg micronized vaginal progesterone, , daily which is
identical to progesterone of ovarian origin. Other control group of 27 pregnant women received no
treatment, outcome regarding preterm labor before 32weeks was evaluated, together with neonatal
outcome .
Results: the study shows, 1-the incidence of preterm labor was low in progesterone group when
compared with the other group. 2- admission to baby care unit was lower in 1st group, with shorter
stay.
Conclusion : vaginal progesterone may reduce the risk of preterm labor in women with short cervix.

Background: First description of IHPS by Fabicious Hildnris in 1640. Harold Hirshsprung described
2 cases in 1888 at that time the treatment was medical by gastric lavage and antispasmodic [1].
Ramistedtʼs (1911) later simplified the Fredetʼs (pyloromyotomy).[2]
Aim of study :To study the clinical presentation ,diagnosis ,management and complication of infants
with IHPS in Children Welfare teaching hospital.
Patients and Methods: Prospective study of 68 cases of IHPS treated and followed up in children
welfare teaching hospital between March 2006 to March 2008
Results:Male to female ratio was 5.8-1.first baby in the family more frequently affected by the
disease(70.6%).All patient when full term andthere was no family history of the disease in our
study.The peak incidence for time of presentation between 3-6weeks.97% of the cases presented with
projectile non bilestianed vomiting.the diagnosis based on history and clinical examination in 76.5% of
the caseswhile ultrasound examination was true positive in 100% of cases.The classical ramistedtʼs
pyloromyotomy was done for all our patientS .Post operative persistent vomitingevedent in
26.5%ofcases and it self limiting.No death occured.
Conclusion: Early diagnosis,proper resuscitation and close follow up for apatient presented with IHPS
will decrease the incidence of complications.the clinical diagnosis obviates the need for further
diagnostic tools.Ramistedtsʼ-Fredetʼs pyloromytomy remains the procedure of choice in treating IHPS.

Aortic regurgitation is back flow of the blood from the aorta to the left ventricle, many causes of this
relatively common valvular lesion but one of the most important is hypertension a so common medical
problem.
Aim of the study: to assess the frequency of, severity and risk factors of aortic regurgitation in
hypertensive patients
The results and discussion: show significant No. of hypertensive patients have aortic regurgitation most
of them have non significant lesion with the dilatation of aortic root and increasing age are significant
risk factors ,this finding consistent with most of the studies
Recommendations: it is wise to assess all hypertensive patients with noninvasive simple test,
echocardiography, for evidence of aortic regurgitation.

Background:Congenital abdominal wall defects(probably omphalocele) were described as early as the
first century. Successful repair of omphalocele was first reported in 1803.[1] Excising sac and covering
the viscera with skin flaps was described in 1948[2]. In 1967, the staged repair of omphalocele with
artificial material sewn to the facial edges was introduced [3].
Objectives: To evaluate the prenatal diagnosis, post delivery management including surgical
correction and prognosis, in Iraq.
Setting: All of our patients were managed in pediatric surgery center at children welfare teaching
hospital in Baghdad between may 2004 to may 2007.
Patients and methods :The medical records of our patients were recorded for prenatal diagnosis, birth
order, sex, weight, type of delivery, maternal age, gestational age, size of the defect, associated
anomalies, treatment and out come.
All patients had been examined to exclude associated congenital anomalies.
All patients investigated for blood group, blood glucose and urea, echo-cardiography and ultra sound
of abdomen done for them. Vitamin K were given to all patients as 1mg/kg in single dose.
Results: forty full term patients, twenty male and twenty female. Diagnosis of all of patients were
done clinically by inspection, while ten of the patients were diagnosed prenataly by ultrasound
examination(25%).
six of our patients(15%) had C\S delivery while the rest were product of normal vaginal delivery.
Only two patients(5%) had rupture of the sac at presentation. thirty patients(83.4%) treated
successfully by primary closure, six patients (16.6%)treated by staged closure. four patients(10%)died
preoperativelysecondary to sepsis because of low birth weight and associated anomalies, two
patients(5%) died postoperativelyfor the same reasons.
Conclusion: All our patients were full term infants. No difference in male to female ratio.
Omphalocele minor not interfere with birth weight. C\S have no additional benefit over normal vaginal
delivery. Mortality is high in patients have major associated anomalies or big defect. The treatment is
surgical include removal of the sac and primary closure or staged closure. The post operative period
was smooth for 90% of the patients.

The hypoglycemic effect of orally administered aqueous extract of Ficus carica (F.C.) leaves
against alloxan-induced diabetes in rabbits was studied. Animals were treated daily with 0.3 gm/kg
F.C. aqueous leaves extract alone, or 10 IU/Kg body weight (B.wt) insulin alone, or a combination of
0.3 gm/kg B.wt F.C aqueous leaves extract and 10 IU/Kg B.wt insulin, each started one week after
alloxan injection and continued for 6 weeks period for reversing the change in glucose level in diabetic
rabbits. In addition, diabetic rabbits were randomly selected and received a combination of different
doses of insulin with Ficus carica leaves aqueous extract to evaluate the extent of Ficus carica leaves
aqueous extract in reducing insulin dose compared with diabetic rabbit treated with insulin alone (10
I.U. /Kg). Blood samples were collected weekly from the caudal ear vein of rabbits for the assessment
of blood glucose level. Analysis of data obtained from the first experiment showed that, 0.3 gm/kg
B.wt. of aqueous extract of F.C. leaves given alone or in combination with insulin caused an
improvement of blood glucose level in diabetic rabbits compared to diabetic non-treated group. The
results from the second experiment showed that, there were no significant differences between 8 U/kg
insulin and 0.3gm/kg Ficus carica leaves aqueous extract group compared to 10 U/kg insulin, thus
there were a reduction in insulin dose to almost 20% produced by Ficus carica leaves aqueous extract.
In conclusion, Ficus carica leaves aqueous extract has the ability for decreasing glucose level and may
have additional effect to insulin, and could be used as a supplement with insulin in order to improve its
effect and/or reduced its doses and hence reduces its suspected side effects.
Address correspondence: Dr. Nada N. Al-Shawi, Department of Pharmacology and Toxicology,
College of Pharmacy, University of Baghdad. Email: nadaalshawi@yahoo.com.

The aim: To find out the main problems affecting the nutrition of children.
Methods: An observational study was done on 134 children 6 months -2 years of age who admitted to
nutrition rehabilitation center of Babylon teaching hospital for maternity and children from 1\6\20071\6\2008. The growth of these children is -2SD and below.
Results: We found there is no significant differences between the number of children who where on
breast feeding 63 (47%) and the number of children who where on bottle feeding 71 (53%). We also
found the largest group of malnourished children are those who are started complementary food too
later (from 10 months-1 year of age) 90 (67.3%) , followed by 30 (22.3%), 12 (9%) and 2 (1.4%) for
those who started complementary food at age > 12 m, 7m-9m and 4m-6m respectively. About maternal
education we found the largest group of malnourished children is those who's their mothers finished
primary school (56%). We found the number of malnourished children below 1 year of age 84
(62.75%) is more than those above 1 year of age 50 (37.3%). The number of malnourished children
from crowded family (with 4-6 sibling) are 69 (51.5%) more than less crowded families. There are no
significant differences between number of malnourished children from urban 69 (51.5%) and those
from rural area 65 (48.5%). We found those children on breast feeding (65%) responding to treatment
with F 100 milk significantly more than those on artificial feeding (35%).
Conclusions: These findings revealed that the important risk factor for developing malnutrition is
delayed complementary feeding with the superiority of breast feeding on artificial feeding in
decreasing the risk for malnutrition and in the acceptance of complementary food beyond 6 months of
age.

Background: Dehydration is the leading cause of death in diarrheal diseases. Poverty, lack of safe
water and sanitation, early motherhood, inadequate health care, and lack of breast feeding have been
associated with a poor prognosis for diarrhea among young children.
Aim: To identify risk factors for development of dehydration in children below five year old with
acute diarrhea.
Patients and method: A case- control study was conducted to determine the risk factors for
development of moderate to severe dehydration. A total of 200 children comprising 100 cases
(moderate or severe dehydration) and 100 controls (non or mild dehydration) up to 5 years of age
suffering from acute diarrhea were studied. Fourteen variables were investigated as risk factors.
Results: By univariate analysis, Infancy, malnutrition, cessation of breast feeding, cessation or
reduction of fluid and ORS during diarrheal episode, and no washing of mothers hand before
preparation of food, after defecation and after disposal of feces, were identified as significant risk
factors for development of moderate to sever dehydration in acute diarrhea.
Conclusion: These findings may be useful for formulating intervention strategies for preventing death
due to diarrheal dehydration.

A five hundred and thirty one (531) on the counter (OTC) non-steroidal anti-inflammatory drugs
(NSAIDs) users, were directly interviewed by pre-structured questionares. The study was conducted at
Rheumatology and rehabilitation unit of Merjan teaching hospital in period from March 2008 to
August 2008. The items of pre-structured questionare, measures the knowledge and the attitude of
patients toward the use of these medications.
The results showed that most of studied users were not using these agents correctly and frequently
ignore the potential adverse effects.
Lack of knowledge of most of users, and lack of direct or labeled instructions were considered the
corner stone for abusing these hazardous agents.

Background: Thyroid disorders are common problems with significant public health implications.
Early detection and treatment of these disorders can prevent serious morbidity. The frequency of
abnormal thyroid hormones profile and its relationship to traditional thyroidal symptoms particularly in
individuals with subclinical thyroid dysfunction remain unclear.
Objective: To determine the abnormal thyroid hormone profile in a large number of individuals
referred to a consultant laboratory in Sulaimania.
Material and methods: A total of 9795 individuals referred to Alshahid – Hadi Consultant Hormonal
Laboratory in Sulaimania were invited to participate in the study with a questionnaire and blood
samples.
Results: Patients with previously diagnosed hypo- and hyperthyroidism were 11.2% and 4.9% in
females and 8.4% and 4.0% in males respectively. In females, the percentage of both hypo- and
hyperthyroidism increased with age while in males, the percentage of thyroid dysfunction increased
with age reaching the peaks at 6th decade for hypothyroidism and 5th decade for hyperthyroidism after
which they tend to decline. Abnormalities of thyroid hormones profile among the previously diagnosed
patients treated by thyroidectomy, carbimazole and thyroxine were 20.9%, 8.9% and 19.3%
respectively. Thyroid hormones profile confirmed the initial clinical diagnosis of hypo-and
hyperthyroidism in 16.3% and 14.5% respectively. The frequency of both elevated and suppressed
TSH levels in individuals without former or present thyroid disorders were higher in females (6.5%
and 1.0%) than males (3.8% and 0.68%) respectively and were higher at an older age group (> 45
years).
Conclusions: The present study showed that abnormal thyroid hormones profile occurs frequently in
patients at older age groups. Clinical and laboratory follow up may be essential to prevent disease
progression in those who have abnormal TSH level alone without obvious cause. Abnormal thyroid
hormones profiles were recorded in a large number of patients taking thyroid medications or have had
thyroidectomy.

In this work , cysteine proteinase produced by Entamoeba histolytica trophozoite had been
detected. The isolated enzyme had been immobilized by using calcium alginate, and compaired
between free enzyme (mobile) and immobilized enzyme through differente range of pH and
tempreture. We found that immobilized enzyme remains with its enzymatic activity through changing
in pH level and temperature in comparison with free enzyme.

Background: The vertebral hemangiomas are the most common benign spinal neoplasms has been
differently reported from 10 to 27% based on autopsy series, plain X-rays and MRI reviews.
Patients and method: In this study, we reviewed consecutive 700 standard spinal MRI with axial and
sagital T1 weighted and T2 weighted images looking for hemangiomas.
Results: In this study, the incidence of hemangioma was 26%, more common in females (31%) than
males (18.5%), in older age group and in lumbar spine. Most hemangiomas (65%) were less than 10
mm in diameter. Multiple hemangiomas were seen in 33% of cases.
Discussion: The results of this study are similar to another Mediterranean study reported based on
MRI findings, but differ from other reports using X-ray or autopsy as diagnostic tool, suggesting the
influence of either the race or the sensitivity of the diagnostic tool on the incidence of vertebral
hemangioma.

Fixed orthodontic appliances used to treat cases of bilateral distal ectopic eruption of the
permanent mandibular central incisors. A total of 27 Iraqi children at average age of 7.5-years old
selected for the study. 15 patients (9 females and 6 males) treated by extraction of the retained primary
teeth and placement of fixed appliances for alignment and repositioning of the mandibular permanent
incisors. while 7 patients (3 females and 4 males) treated by extraction of the corresponding retained
primary tooth and later alignment of the mandibular incisors, and 5 patients (2 females and 3 males)
treated by extraction of the relevant permanent lateral incisors and the corresponding retained primary
teeth.
The result of present study showed significant difference between the first method of early
mechanical orthodontic and another two methods of later mechanical orthodontic treatment regarding
time consuming, esthetic and complexity factors. No significant differences clinically between gender
groups and sides in the jaw. clinically the first method was easier and faster if compared with other
methods of later orthodontic mechanical which may need a serial extraction, expansion or other
orthodontic intervention that increase the complexity of cases treatment.

This study evaluated the effect of hemorrhoids on the levels of antioxidants such as vitamin E and
C, as well as the malondialdehyde(MDA) levels as the end product of lipid peroxidation and
peroxynitrite (ONOO-) levels as a parameter of peroxidative stress for 35 patients(20 males,15
females) affected by hemorrhoids, before and after rubber band ligation by using baron band ligation
device compared with healthy control groups of 35(20 males, 15 females) .
It has been found that the levels of vit. E and C are significantly decreased, where as the MDA and
peroxynitrite levels are increased among patients (males and females) before the treatment compared
with controls, while the vitamins values are significantly increased when the MDA and
peroxynitrite(ONOO-) levels are non significantly decreased after 7 days of treatment which is safe and
easy procedure. The results suggest that the measurement of lipid peroxidation and peroxidative
product matched with evaluation of antioxidants, may be a best indictors for that hemorrhoids induce
oxidative stress compared with healthy controls and the treatment, due to decrease of oxidative stress
and tissue damage.