Al-Kindy College Medical Journal

AbstractBackground:Reduced glomeular filtration rate isassociated with increasedmorbidity in patientswith coronary arterydisease.Objectives :To analyze the declining eGFR andmortality risks in a patients with Chronic KidneyDisease and have had Coronary Artery Diseaseincluding risk factors .Patientsand Methods:The study included (160)patientsbetween the ages of 16 and 87years.Glomerular filtration rate was estimated (eGFR)using the Modification of Diet in Renal Diseaseequationand was categorized in the ranges<60 mL· min−1 per 1.73 m2and≥ 60 ml/min/1.73 m2.Baseline risk factors were analyzed by category ofeGFR,.The studied patients in emergencydepartment, were investigatedusing Coxproportional hazard models adjusting for traditionalrisk factors.Results:The study included (106) male (54)and female (52) between the ages of 16 and87Years mean age (54.9±15.2).The eGFR dataare calculated for all randomized studiedPatientseGFR <60ml/min/1.73 m287 (82%),and group of patients with eGFR ≥60ml/min/1.73 m219(18%). Overall there was(44) death 42% mortality risk. Patients witheGFR≥60 ml/min/1.73m219(18%), positivehistory of (CAD) is 3 (15.8%) and negativehistory of (CAD) is16 (84.2%, P=0.0001).group with reduced eGFR <60 ml/min/1.73 m2and positive history of (CAD) 42(48.2%), andwith negative history is 45(51.8%). In eGFR≥60ml/min/1.73 m2group and positive historyof (CAD), the mortality rate is2 (10.5%) and innegative history (CAD) group is 17 (89.5%)Conclusion:This study concluded that impaired GFR,in an adult population, is independentlyassociated with significant levels of increasedrisk of mortality of fatal and nonfatal coronaryevents ,e GFR change over time addsprognostic information to traditional mortalityrisk predictors among patients withchronic

AbstractBackground:Psoriasis is an inflammatorydiseasewhichcan be associated with otherdiseases, which may have amajor impact onpatientslife. Psoriasis has also been reported tobe associated with metabolic disorders.Metabolic syndrome(MS)isa combination ofmedicaldisorders that, when occurring together,increasesthe risk of development ofcardiovasculardiseasesanddiabetes.It affectsone in five people in the United States andtheprevalence increases with age. Some studieshave showntheprevalencein the USA to be anestimated 25% of the population.Objective:To investigate the prevalence ofmetabolic syndrome in patients with psoriasis.Methods: We performed a hospital-based case-

Background: Fractures of the humeral shaft
accounting for approximately 3% of all
fractures. There is a wide array of good
options for their treatment and controversy
over the best methods. Although good
techniques of osteosynthesis are available, the
aim of this article is toemphasize on the benefit
and good outcome of conservative treatment
for properly selected cases to decrease the cost
and avoid the complications of surgery.

Background :Atherosclerosis is the most
frequent underlying cause of ischemic heart
disease and a major cause of death all over the
world. This study was carried out to analyze and
compare the angiographic findings in patients
with diabetes mellitus versus non diabetics with
coronary heart disease , and to correlate these
findings with some risk factors for coronary
heart disease.
Methods: A total of 100 patients were studied,
50 with diabetes mellitus, and 50 non diabetics.
This study was carried out at Al-Sadr teaching
hospital in Basrah, Southern Iraq during the
period April 2009- September 2009. All patients
were known to have coronary heart disease. Risk
factors for coronary heart disease were studied
and coronary angiography was performed to
define coronary lesions for all patients, and were
classified into those who had single , two , three
or four vessels disease, according to the number
of critical coronary vessels involed. Angiography
was considered as normal when the test did not
identify any obstruction of any major epicardial
artery.
Results: Diabetic patients had more multi-vessels
involvement coronary heart disease than non
diabetics. Right coronary artery, left main stem
artery, left circumflex artery involvement and left
ventricular systolic dysfunction were seen more
in diabetics than non diabetic patients.
Conclusions: This study showed that diabetic
patients had more critical multi-vessels
involvement than non diabetic. Diabetic patients
had also worse coronary angiographic findings
independent on the presence or absence of other
risk factors

Background: Disc battery ingestion is a common
serious problem in Iraq. It increase in the last years
because of the increase in number of electronic toys
that uses these batteries. These batteries contains
many types of irritant chemicals that increases the
risk of it's ingestion.
Methods:We reviewed the medical records of
children aged between 1year and 7 years
old admitted to Surgical Specialty Hospital/Baghdad
Medical City due to disc battery ingestion from
January 2007 through December 2010). The diagnosis
of disc battery ingestion was based upon history,
clinical symptoms, and results of imaging studies.
The clinical data reviewed included sex, age, clinical
manifestation and duration of symptoms, hospital
course, imaging findings, and endoscopic results.
Results: 50 patients were admitted to Thoracic and
vascular Department/Surgical Speciality
Hospital/Baghdad Medical city Complex (26 males
and 24 females) of disc battery ingestion with a mean
age of 1.873 years (range, 7 months to 7 years).
Fourty one patients had Symptoms of Dysphagia,
vomiting, nausea, and abdominal pain. Four cases
with no history of disc battery ingestion and were
accidentally found by X ray studies. Two patients
complained from Aspiration and chalking, two
patients had mediastinitis and died at later on due to
sepsis, and only one case had surgical emphysema.
Thirty-eight cases had their batteries impacted in the
upper esophagus and Nine cases had their batteries
impacted in mid-esophagus, and Three cases had their
battery impacted in the lower-

Background :Thalassemia is an autosomal
disease of the haemoglobin. Two types of
thalassemia are recognized: thalassemia major
and thalassemia intermedia.
The most serious cardiac complication in
thalassemia major is due to multiple blood
transfusions rather than the disease itself, which
is due to iron overload.
Cardiomyopathy is the most common cardiac
defect that occurs with iron overload. Pricarditis,
congestive heart failure and arrhythmias are due
to hemosidrosis and chronic aneamia.
Aim of the study: to demonstrate the prevalence
and types of electrocardiographic changes among
thalassemic patients with aged over ten years old.

This study is prospective in nature, It consider
110 patients with vertigo who were assessed
between April and December 2010 at E.N.T out
patient department of otolarygiology, in Al
Diwania teaching hospital, in Diwania city,
Iraq. The study is designed to assess the
incidence of vestibular and non vestibular
vertigo and their association with
tinnitus,hearing loss,migraine in Young adult
and elderly.All patients were assessed by
questionary method and by pure tone
Audiometry.
Results: the incidence of vestibular vertigo was
69.1% while non vestibular vertigo is 30.9 %,
vestibular vertigo was inversely related to the
age while non vestibular vertigo directly related
to the age
The percentage of association between
tinnitus, migraine, hearing loss with
vestibular and non vestibular vertigo were
{71%,6%),(29%,35%),(74%,18%)}
correspondingly.
Conclusion; vestibular vertigo was more
common than non vestibular vertigo in young
adult and elderly, and it is significantly
associated with tinnituswith migraine.

Background: Humeral diaphyseal fracture usually
heals with closed methods but when nonunion
develops then it needs surgical intervention in the
form of plating and bone grafting, intramedulary
nailing (open or closed simple or interlocking nails)
and external fixators (circular or one plane fixator).
In our unit we treated non union humeral
diaphyseal fracture with plating and bone grafting
shortening of fracture ends up to 4 to 5cm when
needed. Methods: This study was conducted at
Orthopaedic Department of AL-Sadar General
Hospital from January 2004 till December2005 .
We included 20 cases with atrophic non-union in
12(60%) and hypertrophic non-union in 8 (40%)
patients. All atrophic non-union were treated with
plating, bone shortening by transverse osteotomy
and bone grafting, while hypertrophic non-union
were treated with decortications of non-union ends
and fixation with compression plates, with bone
grafting in old age. Follow up measures were based
on clinical (range of joints motion) and radiological
(healing) findings. Follow up was done for upto 6
months . Results: Out of 20 patients the age range
was 20- 60 years, 16 (80%)were male and 4(20%)
female. Right humerus involved in 15( 75 %)
while left humerus in 5( 25%) patients.
In12(60%) patients with atrophic non union bone
shortening by transverse cut osteotomy was done
while in remaining patients with hypertrophic nonunion
plating was done in 2( 10 %) cases and
plating with bone grafting in 6( 30%) patients.
Union was achieved in all patients after 16 to 20
weeks of surgery. In one patient ( 5 %) of 75 years
age with hypertrophic non-union implant was
loosened after 3 months of surgery. At that time
healing (Union) was evident on X-rays and humeral
brace was applied for further 3 months. Two
patients( 10 %) got neuropraxia of radial nerve
which resolved with in 3 months time. 2 patients
(10 %) developed shoulder stiffness which resolved
after exercise. Conclusion: In Non Union of
Humerus shortening by transverse osteotomy &
rigid fixation with plates give excellent results in
selected cases.

Background: A basic knowledge and understanding
of first aid can be invaluable for individuals to be
able to provide emergency care in the event of an
accident, possibly saving lives and minimizing
injury. Since injury is the fifth leading cause of death
and children at the age of primary school are liable
for accidents and lack of knowledge and good
judgment of their teachers may lead to dangerous
consequences when emergencies occur. Training
teachers how to deal with accidents is of obvious
importance.
Objectives: To estimate the adequacy of primary
school teachers’ knowledge of first aid concerning
external bleeding and fractures and Whether there's a
difference in knowledge in regard to years spent in
teaching or the teaching subject and to decide
whether primary school teachers need training or not.
Methods: This study is a cross-sectional Study was
done over 5 months (from 01/Dec/2010 to 01/May/
2011) in five randomly chosen primary schools in
different regions in Baghdad/ Al-Rusafa,carried out
on 100 primary school teachers without inclusion or
exclusion criteria.
Statistical analysis: Chi-Square was calculated by
MiniTab Program to estimate significance. The
significance level was set at P<0.05.
Results: Of the 100 participants, 4% had good
knowledge, 19% had fair knowledge and 77% had
poor knowledge, 26% were science teachers, 9%
were social studies teachers, 43% were literature
teachers and 22% were sport/art teachers. No
significant difference was found for their knowledge
(p value=0.41).Also participants were classified
according to the years they spent in teaching. No
significance was found for their knowledge (p
value=0.82).
Conclusions: Primary school teachers' knowledge of
first aid concerning external bleeding and fractures is
poor and certainly inadequate.No difference was
found in regard to how many years spent in teaching
and difference in teaching subjects also has no effect
on their knowledge.

Hypospadias, Tubularized incised plate (TIP),, Dartos flap,, V like incision, Fistulae.

Background; paraphilias were studied in the sex
clinic, at Al-Rashad teaching mental hospital, in the
years 2009-2010, a subject never touched before in the
field of psychiatry in Iraq.
Aims of the study :
1-to identify the prevalence of types and number of
paraphilias in those patients.
2-to study the relationship of paraphilias with
sociodemographic factors of the patients.
Patients and methods; using the diagnostic criteria of
DSM IV TR, 52 patients from the outpatient sex clinic
at Al-Rashad mental hospital, collected and studied (41
males and 11 females).
Results; the ratio of men to women was 3.7 : 1, the
majority of our sample was in the age range of 21-30
years (36.35%), with a limited(primary education)(
about 48%) or no education(36.53%), not married as a
status was found in 48.07%, and low socio-economic
level was in 57.69% of our sample. Exhibitionism was
found in 19.23% of our sample, followed by zoophilia
in males 17.07%, most of the disorders were found
exclusively in males, apart from masochism and some
of the paraphilias not otherwise specified (NOS).
Conclusion; paraphilia as a group of disorders, exist in
our society, but lurks in the shadows of our strict
cultural and religious societal background, they are
suppressed and stigmatized, for the majority of our
patients were collected first in a private clinic, then
directed and encouraged to the sex clinic by the
researchers.

Back ground: In Iraq, after 2003 had more
accidents of the shell, bullet and stab abdominal
wounds, more over colon injuries.
Objective: The aim of this study is to evaluate
the most appropriate management of penetrating
colon injuries, comparing the primary repair with
the diversion.
Methods: Eighty patient series with shell, bullet
and stab colonic injuries during 4.5 years period
from June 2006-december 2010 at Al-Yarmouk
teaching hospital. The study compared the use of
primary repair versus diversion, analyzing
variables such as sex, age, severity of injury and
mortality rate.
Results: there were total 80 patients ,62 (77.5%)
male and 18(22.5%) female .male :female ratio
3.4:1. the most affected age group was 21-30
years. 47 patients 58.75% were shell injuries.28
patients 35% were bullet injuries. 5 patients
6.25% were stab wounds. 46 patients 57.5%
managed by primary repair ,one of them 1.25%
died, while diversion in34patients 42.5%
different grades of colon injuries ,5 of them
6.25% died ,this was due to different factors such
as multiple organ injuries and post operative
complications.
Conclusion: the primary repair is safe and
effective regarding morbidity and mortality in
the management of grade II, III penetrating colon
injuries with minimal risk factors as compared to
diversion.

Background: Obesity represents a clear and
present danger to the health of children and
adolescents. Its prevalence among American
youth has doubled in the past 3 decades, and
there are now more overweight and obese
adults in the United States than adults of
normal weight.
Objectives of the study:
1- Finding whether screen watching among
adolescents has an effect on increasing
prevalence overweight and obesity.
2- The effect of other variables like physical
activity, eating in front of screen, eating under
stress on obesity and overweight among the
subjects sample.
Patients &Methods: During 3 months period a
cross sectional survey was conducted on 4
high schools at Baghdad with total sample of
500 subjects using time table to assess screen
watching hours per week,
Results:Higher percentagesof overweight &
obesity were found among female adolescents
than males, significant associations was
obvious among total sample & male sample
betweenthe level of physical activity &
BMI,while there was no significant
association among female sample for the same
variables , There was obvious significant
association between BMI a time spending in
screen watching, eatingin front of screen, ,
eating under stressin the total & male samples.
Conclusion: Increased levels of physical
activity are associated with a lower BMI and
less time spent on screen watching .in addition
.stress-induced eating may be one factor
contributing to the development of obesity;
furthermore habits like eating in front of
screen could increase BMI of an adolescent.

Back ground: Skin grafting is the most common form
of reconstructive surgery, and regeneration of
sensations in skin grafts is a complex process
influenced by many factors such as , the thickness of
the graft, the depth of the grafted bed, meshing of the
graft, the condition of the bed and the surrounding
area. So many studies performed on this subject, some
of them clinically based on subjective type of sensation
tests, and others histological to detect the presence of
nerve fibers in the grafted skin
Objectives: To detect return of sensations to split
thickness skin grafts by clinical methods.
Methods: From Oct. 1995 to Oct. 2010, a clinical
prospective study performed in Al wasity Hospital for
reconstructive surgery, Hilla teaching General
Hospital, and Al kindy teaching General Hospital on
recovery of sensations in human split thickness skin
grafts on 200 patients, 400 grafts. There were 120
male, 80 female patients, there ages ranged from20 -61
years with mean of 28 years. The regeneration of
sensation of pain, touch, cold, and warmth, was studied
with the usual clinical methods. We studied; different
graft thicknesses, depth of graft beds, meshing of the
grafts, grafts on early and late wound excisions
Results: in our study the regeneration of sensations
occurred in the following order; pain, touch, cold ,
warmth, and has been found to extend over a period of
16days to 3 months, and sensations improve with time
but never recover completely even after several years.
Conclusion: The recovery of sensation of grafted skin
is a complex process that is influenced by many
factors; some of them are related to the graft, to the
recipient bed, to the patient as a whole, and occurs if
the graft is applied on a sufficiently innervated bed.

Back ground: Oral isotretinoin is recommended
for sever nodulocystic acne in the doses 0.5-
2mg/kg/day which is usually associated with higher
incidence of adverse effects. To reduce the
incidence of side-effects and to make it more costeffective,
the lower dose regimen of isotretinoin has
been used.
Aim: To compare the efficacy and tolerability of
oral isotretinoin 10mg and 20mg/day in acne
vulgaris.
Methods: one hundred and twenty patients with
acne vulgaris were randomized into two treatment
regimens each consisting of 60 patients. The first
was treated with 10mg/day and the second group
with 20mg/day for 24 weeks. Fifty five patients
from the first group and 47 patients from the second
group who continued the study for 24 week and 8
weeks after cessation of therapy. The response rate
was recorded in the form of acne load and acne
grade initially, during treatment and after 8 from
stopping treatment. Side effects were also recorded
in both groups.
Results: The response rate in both groups was
comparable in mild, moderate, and severe acne
vulgaris patients. Frequency and severity of
treatment-related side-effects were significantly
higher in the second group as compared to the first
group.
Conclusion: 10mg/dayisotretinoin can be used in
the treatment of mild, moderate and severe acne
with less side effects as compared to 20mg/day.

Background: Osteoarthritis (OA) currently seems
inevitable and unavoidable for a large swath of the
population .its etiology relates to a strong ,but
complex ,non mendelian genetic basis ,combined
with mechanical and metabolic factors that cause
molecular alterations the end results of which
affect the whole joint .Glucosamine and
chondrotin sulfate alone or in combination may be
of benefit to a subgroup of individuals who have
knee pain due to OA.
Glucosamine has been shown to alter cartiage turn
over in patients with OA undergoing physical
training
Aim of the study: To find the validity of
glucosamine chondrotin sulfate in treatment of
grade 1 and 2 OA.
Methods: the sample of 280 patients (418 knee)
were divided in to two groups , group A (132
patient) treated by classical methods by
glucosamine chondrotin sulfate for one year. For
both groups different parameters were used
including pain stiffness effusion crepitus and genu
varum and different radiological findings and we
used MRI for evaluation pre and post treatment
Result: Female/ male ratio was 2.89 the highest
age group was ( 60-69) year regarding the clinical
presentation of patients the commonest clinical
presentation were pain and stiffness and the MRI
finding including bone marrow edema shows good
indicator for response to treatment .
Conclusion: Pain ,stiffness and crepitus were
common presentation of OARelief of pain
andstiffness were related to decrease of effusion
and bone marrow edema which is the result of
using nonsteroidal anti-inflammatory drugs with
glucosamine chondroitin sulfate more than when
non steroidal anti- inflammatory drugs alone.

Introduction: The association between acute stroke and
renal function is well known. The aim of this study is to
know which group of patients with acute stroke is more
likely to have undiagnosed Chronic Kidney Disease and
which risk factors are more likely to be associated with.
Methods:We studied 77 patients who were diagnosed to
have an acute stroke.Patients were selected between
April2011andJune 2011 using the " 4-variable
Modification of
Diet in Renal Disease Formula " which estimates
Glomerular Filtration Rate using four variables :serum
creatinine ,age ,race and gender.
Results :The study included 38 male and 39 females
patients ,aged (35-95) years. Glomerular Filtration Rate in
patients with acute stroke was calculated and showed
37.6% , 28.5% , 25.6% , 6.4% and 2.5% (Chronic Kidney
Disease stage 0, 1,2,3,4,5 respectively.)
Conclusion :One Third of patients with acute stroke had
Glomerular Filtration Rate less than 60ml/min per 1.73m²
patients who had more than 2 risk factors of Chronic
Kidney Disease are about 3 times more likely to have
Glomerular Filtration Rate less than 60 ml/min per
1.73m² to those with 2 or less risk factors

Background:Wilson’s disease (WD) is an inherited
disorder of copper metabolism that is characterized
by tremendous variation in the clinical presentation.
Objective: To assess demographic distribution,
clinical presentations, diagnostic evaluation, and any
association between clinical presentations and other
studied variables of a sample of Iraqi patients with
WD.
Methods: A descriptive cross sectional study with
analytic elements was conducted during 2011, from
the 1st of February till the 10th of June. The sampling
method was a convenient non-random one, carried
out through consecutive pooling of registered WD
patients. A questionnaire-form paper had been
developed for the process of data collection.
Results: The study had enrolled 29 patients, with a
male to female ratio of (1.07:1), their mean age was
27.12±12.18 years. 82.8% of them lived in urban
area. 48.3% were singles. Only 20.7% of patients had
a positive family history of WD. 69% of patients had
consanguineous parents. The main initial clinical
presentations were; hepato-neurologic (31%), pure
hepatic (27.6%), neuro-psychiatric (13.8%) and other
presentations (27.6%). Hepatic manifestations were
seen in (82.8%) of patients; jaundice was the most
frequent (89.7%). Ophthalmologic manifestations in
(55.1%) of patients including; Kayser-Fleischer rings
(51.7%), diplopia (6.9%) and cataracts (3.4%).
Neurologic manifestations existed in 44.8% of
patients; tremors were the most frequent (41.4%).
Psychiatric manifestations existed in 31% of patients;
depression was the commonest (27.6%). Joints
manifestations existed in 20.7% of patients. The
diagnosis delay was 11.26±8.2 months.
Conclusion: The higher percentage of patients were
of hepato-neurologic and pure hepatic presentations.
Patients with hepato-neurologic type are diagnosed in
older age, while those with neuro-psychiatric type are
diagnosed in younger age and with longer diagnosis
delay.

Background : Coronary artery disease is theunderlying cause in approximately two thirds of
patients with systolic heart failure ;
Coronary artery angiogriphy may be useful to
define the presence ,
Anatomical characteristics ,and functional
significance of Coronary artery disease in
selected heart failure patients with or without signs
and aymptoms of Coronary artery disease.
Objectives: to verify the clinical usefulness of
coronary angiography (CA) in congestive heart
failure (CHF) patients with no history of ischemic
heart disease and to identify predictive factors for
performing coronary angiography to patients with
congestive heart failure with no obvious ischemia.
Methods :this is a cross-sestional study conducted
Ibn al –Bitar center for cardiac surgery during a
period between November 2009 and November
2010 ;all included patients have symptomatic LV
dyfunctional with NYHA functional class II or
more with no clinical evidence of IHD .History,
physical examination had been performed for each
patient , in addition ti blood tests ,ECG ,CXR,
echocardiography and Coronary angiogriphy
Results :Among 112 patients with symptomatic
LV dysfunction of unknown cause enrolled in this
study male :female ratio 3:1 their age (17 -77 years
)there were 14 patients (12.5%)with significant
Coronary artery disease , statistical analysis
between CADand non CAD group show :the CAD
were more common in male 11 patients (78% )
smokers(1)Were female , 25 patients (22.3%) were
diabetic , 25 diabetic (22.3%) were hypertensive
,50 diabetic (44.6%) were smokers . 4 diabetic3.5) with family history of dilatedhyperlipidemia and 3 diabetic (2.6%) ) with
family history ischemic heart disease (IHD in
close relative at age <50 years in men and <55
years in women ) as demographic distribution of
patients in table 1 .coronary angiography show
that are 14 patients (12.5%) with significant
coronary artery disease (CAD) and 98 patients
(87.5%) with significant coronary artery disease
. as shown in figure 1 . eleven patients (78%) of
patients (22%) were female statistical analysis
shows that the male is more predominant in
CAD groups as shown in table 2 . twelve
patients (85.7%) of patients with CAD were
smokers while only 38 patients (38.7%) were
smokers in non CAD group . statistical analysis
shows there is significant difference between
the two groups ( p value < 0.01 ) as shown in
table 3 .nine patients (64.2%) of patients with
CAD were diabetics while 16 patients
(16.3%)were diabetics in non CAD group ,
statistical analysis shows there is significant
difference between the two groups (p value <
0.005) as shown in table (3) .there is no
statistical between the mean of left ventricular
ejection fraction of CAD group ( 37 ±10 %) and
that of non CAD (36±9 % ) , p value > 0.5 as
shown in table 6 . figure 2 revealed that LAD
lesion was most common coronary artery lesion
which represent 12 (85%) followed by in order
of frequency LCX 42 % ,RCA 28% and LMS
7% ; in addition to that 57% with single vessel
disease ,14.2% with 2 vessel disease and
28.4%with r vessel disease (2)Leads , ST
depression ≥1 mm or deep T wave inversion
had been excluded

Background: Although expression of the HER-
2/neuoncogene may be of some prognostic importance
in advanced ovarian cancer, its role in early-stage
disease has not been established. The current study
examined the prevalence and significance of HER-
2/neu expression in different grades of different types
of surface epithelial ovarian carcinoma.
Methods: Thirty eight female patients with surface
epithelial ovarian cancer were included in this study.
The blocks of corresponding formalin fixed, paraffinembedded
ovarian biopsies were retrieved from the
archives and hematoxylin-eosin slides of each ovarian
biopsy were reviewed and marked their grades of
differentiation , then a new sections from each sample
stained by her2/neu as immunohistochemical
technique and classified according to degree of
intensity regarding to dependable scoring system ,
also ten cases taken as control group from normal
ovarian tissue.
Results :-Thirty eight sample of surface ovarian
carcinoma were collected , twenty six were serous
ovarian carcinoma , eleven cases were mucinous
carcinoma type and one case was endometriod
carcinoma . The samples were classified according to
their histological types and according to their grading .
The mean age of SC type was 54.52 with SD 7.17
while the mean age of mucinous carcinoma was 49.36
with SD 4.9. There is no significant relation between
each type and grading system ( P Value = 0.9 ) ,also
there is no significant relation between age group
distribution and types of ovarian carcinoma ( P value
= 0.14 ).Instate that statically no significant relation
between intensity of expression Her2/neu and high
grading of each types of collected sample ( P value
=0.22) and this may be due to small sample size but
still there are obvious criteria showing that her2/neu
expression relatively increase in higher grade of each
types of studied ovarian surface epithelial carcinoma.
Conclusion :-In conclusion, the overexpression of
the HER-2/neu gene product appears to be an unusual
occurrence in early epithelial ovarian cancer and may
occur less frequently than in advanced disease. Early
ovarian cancer will eventually progress to advanced
disease if undiagnosed and untreated, then, HER-
2/neu overexpression does not appear to be a general
early event in the development of ovarian cancer.
Instead, it seems that increased expression develops in
many instances after the malignant phenotype has
already arisen.

We presented here a 25years old lady with a multiple hatdtid cysts in lung and liver and spleen in large number in each organ. Which regarded inoperable and difficult to treared.We use medical treatment with antihelimenthes drugs in new regime and follow-up over 1year clinically, laboratory investigations, U/s and CT.scan. There was good disappearance of liver and spleen cysts with very good response in lungs.