Al-Kindy College Medical Journal

Background: Hypertension and dyslipidemia are
cardiovascular risk factors that commonly coexist .
Objective : To evaluate the effects of ß - blocker
(Atenolol) , ACE inhibitor (Captopril) calcium Channel
blocker (Nefidipin ) and diuretics on serum lipid profiles .
Method: Thirty untreated hypertensive and 147
hypertensive patient treated with these antihypertensive
drugs, attending different public health clinics in Basrah
pronivce were enrolled in this study .
Serum lipid profile were determined enzymaticaly using kits
from BioMerieux, France .
Result : The study has revealed that ß-blocker do not
significantly affect total cholesterol ( TC ) and LDLcholesterol , but increase significantly triglyceride (TG) and
VLDL – cholesterol and decrease HDL – cholesterol.
Diuretics causes a significant elevation of TG with generally
no significant changes in TC , LDL – cholesterol , VLDL –
cholesterol and HDL-cholesterol. ACE inhibitor and calcium
channel blockers appears to have no significant effect on
plasma lipids .
Conclusion :It may important to measure blood lipid levels
to identify pre-existing hyperlipidemia before starting the
antihypertensive therapy and to select antihypertensive agent
that will not influence the lipid profile or interfere with the
therapy of hyperlipidemi

Background: Leukemia is a group of malignant disorders
associated with increased numbers of blood white blood
cells. Acute leukemia occurs at all ages. Because zinc
influences many body systems and functions, zinc is an
essential nutrient for tissue growth, cellular division,
protein synthesis DNA and RNA replication it also ought to
play a critical role in the growth of tumor. In this study,
serum zinc was estimated in leukemic patients and
compared with healthy subjects.
Methods: The subjects in the present study were; fourtyfour depressed patients aged (14-48 year), thirty-one
apparently healthy subjects were selected as control group.
Their sex and age were comparable to that of patients.
Determination of serum zinc was carried out using flame
atomic absorption spectrophotometer.
Results: The results showed a significant decrease in serum
zinc at (p<0.05) in leukemic patients as compared with
healthy control.
Conclusion: The decrease in serum concentration of zinc in
leukemia can be explained by means of the changes in
immunity system and the need for zinc to synthesize
nucleic acid and tumor cell division in this disorder in
addition to other possible mechanisms

Background: Many previous studies were concerned with
the relationship between gestational diabetes and the
development of vaginal candidiasis in pregnant women. In
this study, our aim is directed to uncover glucose tolerance
status in non-diabetic pregnant women inflicted with
candida albicans.
Methods: Thirty-four pregnant women with vaginal
condidiasis (as demonstrated by microscopy) were enrolled
in this study. The patients were nearly similar in their
anthropometric and demographic criteria with those of the
healthy pregnant women (control group, forty –two
women). Fasting plasma sugar and glucose tolerance test
were alone for all patients and control group.
Results: fasting plasma sugar was significantly higher in
the candidiasis-positive pregnant women in comparison to
those of candidiasis-negative subjects (5.09 mmol/L vs.
4.71, p <0.02). Plasma glucose level after 30 minutes of
performing oral glucose tolerance test was also significant
(8.47mmol/Lvs. 7.84, P <0.04). The same trend of
significance was noticed after 60 minutes and 120 minutes
of performing the corresponding test.
The results were (8.13 mmol/L vs. 7.10, P <0.02) and
(6.90mmol/L vs. 6.15, P<0.05) respectively.
Conclusion: the results reveal an impaired oral glucose
tolerance test in pregnant women with candida albicans

Background: Oral tumors are one of the most challenging
tumors regarding their good prognosis in early diagnosis and
very difficult control in advancing stages.
Objectives: To study the prevalence, types and clinical
presentation of oral tumors in comparison to other oral
lesions among patients attending ENT clinic.
Al-Kindy Col Med J 2008 Vol.5(1) Original Article 11
Methods: This study included 534 patients with different
oral complains attending ENT clinics in AI-Yarmouk
Teaching Hospital, and AI-Kindy Teaching Hospital -
Baghdad, in the period from 1st jan1999 till 31th des 2006 (8
years interval).
Results: The results of this study showed that the prevalence
of malignant lesions was 13.5% (72 out of 534); the males
constitute 59.7 % of them. Premalignant lesions constitute
only 3.9% (21 out of 534) of patients; the males constitute
66.7 % of them. Benign lesions in 8.6% (46 out of 534); the
males constitute 69.6 % of them. Other lesions constitute
74% (395 out of 534); the males constitute 65.8 % of them.
Squamous cell carcinoma is the most common malignant
tumor (found in 71% of malignant lesions).
Conclusions: Most patients are males and the most common
manifestation is sore throat. The most common sign of
presentation is swelling and the most common histological
type of malignant tumors is squamous cell carcinoma (71%).
These patients usually attend ENT clinic seeking for simple
therapy, we see that it’s the job of the otolaryngologist to
diagnose those patients early which has a major influence on
prognosi

Background: psychiatric and behavioral side effects are
common in patients with epilepsy and it may represent an
intrinsic feature of the disease itself or a side effect of the
antiepileptic use. Our aim in the present study is to assess
the psychiatric side effects of Sodium Valproate and
Carbamazipine .as these drugs are the most commonly
used antiepileptic drugs in Iraq.
Methods: 80 patients with primary generalized epilepsy
on Carbamazipine and 50 patients on Sodium Valproate
were enrolled in the present study; all the patients were
assessed for any psychological disturbances using semistructural interview based on the tenth edition of the
international classification of the diseases(ICD 10)
adopted by WHO.
Results: thirty percent of patients taking Sodium
Valproate and (9%) of patients taking Carbamazipine
were found to have depression while (16%) of patients
taking Sodium Valproate and (20%) of patients taking
Carbamazipine were found to have anxiety. There were
no reported psychosis, suicidal attempts, cognitive deficit
and mania in both groups of patients in the present study.
Discussion: Carbamazipine is associated with lower rates
of psychological side effects than Sodium Valproate; this
result may be related to mood stabilization effects of
Carbamazipine.
Conclusion: Carbamazipine is preferred to Sodium
Valproate when the efficacy of both drugs is comparable.

Abstract
The current study was conducted to assess the effect of advancing age on total serum IgE level in asthmatic patients. To this purpose, 90 asthmatic patients and 30 healthy individuals ( control group ) were enrolled. Asthmatic patients were categorized into four groups. Group A consisted of asthmatic patients (9) whose age was more than 20 and up to 30 y. Group B contained asthmatics (13) of age more than 30 and up to 40 y. Group C comprised those (23) of more than 40 and up to 50 y. Group D consisted asthmatic patients (45) of age more than 50 y. Total serum IgE level significantly changed in group D patients when compared with those of groups A and B. The linear regression analysis exhibited significant correlations for IgE (r=-0.65, P<0.001) with ages in asthmatic patients but not in healthy individuals

Background: Morganella morganii is one of the important nosocomial pathogens that may cause urinary tract infection and bacteremia.Methods: The above bacterium was identified from 250 bacterial strains which were isolated from 220 urine samples of patients with urinary tract infection. Antimicrobial susceptibility, by using disk diffusion method, of isolates was tested against some antibiotics.Results: Two M. moganii strains were isolated from female catheterized urinary tract patients, and identified by conventional biochemical tests and API20E system at the first time in Iraq. Both of them produced urease and hemolysin. Antimicrobial susceptibility test showed that these strains are resistant to, amoxicillin-clavulanate, cephalothin, gentamycin, tetracycline, trimethoprim-sulfamethaxzole, penicillin, and piperacillin, while they are sensitive to amikacin, ciprofloxacin, and norfloxacin.Conclusions: M. moganii one of opportunistic uropathogens, especially in catheterized patients. It has produced many virulence factors and exhibited multidrug resistance

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women, at reproductive age. PCOS is a chronic hyperandrogenic state that has many significant short-term and long-term implications for patients such as oligomenorrhea, amenorrhea, infertility, diabetes mellitus, cardiovascular disease, increased risk of endometrial cancer, and hirsutism. Objectives: To evaluate the obesity and glycemic criteria among women with polycystic ovary syndrome. Method: A case control designed study was carried out at the National Diabetes Center (NDC) / Al-Mustansiryia University; on 50 participants formed the PCOS group and 50 healthy control participants. Data collected about age, age at menarche and BMI. Also, blood samples examined for FPG and 2-h OGTT test carried out for all the participants. Moreover hormonal assessment for the LH, FSH and total testosterone were done for all participants. Results : PCOS group women age and age at menarche were 27.62 ± 5.74 and 12.0 ± 1.06 years; vs. the control group were 25.42 ± 4.94 and 11.64 ± 0.69 years respectively. All PCOS group were experienced signs and symptoms of ovarian dysfunction, and infertility while the control group did not experience any of such evidences. BMI showed significant difference between study groups (t-test (P < 0.05)); 98% of the PCOS group was obese vs. 58% of the control group. The waist/hip ratio showed insignificant difference (t-test (P > 0.05). Fasting plasma glucose (FPG) showed insignificant difference between the study groups (t-test (P >0.05); about 18% of the PCOS group was prediabetic (Impaired Fasting Glucose, IFG) (100-125mg/dl) and 6% was diabetic (>126mg/dl) whereas the entire control group was normoglycemic. The OGTT showed significant difference between the study groups (ttest (P < 0.05)); about 22% of the PCOS group was prediabetic (Impaired Glucose Tolerance, IGT) (140- 199mg/dl) and 6% was diabetic (>200mg/dl) whereas the entire control group was normoglycemic. PCOS group showed highly significant elevation in the LH level vs. the control group by about four folds (t-test (P < 0.05)). Also, FSH showed similar elevation by about two folds among the PCOS group vs. the control group (t-test (P < 0.05)). Moreover the LH/FSH ratio was elevated by about two folds among the PCOS group vs. the control group (t-test (P < 0.05)). Total serum testosterone of the PCOS group showed significant raise vs. the control group (t-test (P < 0.05)). Whole the PCOS group had A total testosterone level >60 ng/dL and in contrary the entire control group didn't show any elevation >60ng/dl. Conclusion: obesity of android (central) type was frequent and prevalent among PCOS women. About 20-28% of PCOS women was prediabetic or diabetic due to insulin resistance and decreased insulin sensitivity. Hormonal assay of LH, FSH, LH/FSH ratio and total testosterone were all significantly elevated by two folds or more among the PCOS women. It is not essential that a woman who had polycystic ovaries by ultrasound to have PCOS

Background : Breast cancer is the most common cancer of
women. When breast cancer is detected and treated early,
the chances for survival are better. Surgery is the most
important treatment for non-metastatic breast cancer.
Al-Kindy Col Med J 2008 Vol.5(1) 40 Original Article
Objectives : The aim of this study is to review different
clinical presentation and to evaluate types of surgical
procedures and complications in treatment of nonmetastatic breast cancer.
Method : During the period from Jun 1998 to May 2005,
93 patients with non-metastatic breast cancer were
diagnosed and treated surgically in 2 hospitals in Baghdad (
Hammad Shihab military hospital and Al-Kindy teaching
hospital).
Results : Women constituted ( 98.93% ), while men
constituted (1.07%), with male to female ratio of (0.01:1).
The peak incidence of non-metastatic breast cancer (25.8%)
was at age group 51-60 years, while (60.2 % ) of cases
happened in women over 50 years of age. The right breast
was the most common side affected, and the upper outer
quadrant of the breast was the most common location
affected by cancer. Painless lump (91.4%) was the most
common symptom, and the hard lump was the most
common sign (100%).
The highest frequency of cases was diagnosed in stage II
followed by stage III, and invasive ductal cancer was the
most common histopathologic type.
(87.1 %) of patients underwent modified radical
mastectomy, while (12.9%) underwent breast-conservation
surgery. Breast-conservation surgery carried higher
incidence of recurrent disease than modified radical
mastectomy (33.3% vs.13.6%).
Conclusion : The majority of patients with non-metastatic
breast cancer were over 50 years of age, and the
preponderance were diagnosed in stage II. Modified radical
mastectomy may be preferable method for treatment as it
carries a lower rate of local or distant recurrence than
conventional breast-conservation surgery procedures

Background: The vasoconstricting agents: nor-adrenaline and 5- hydroxytryptamine
(5-HT) have a stimulant action on smooth muscle contractility of the rat vas deferens.
Objective: This study aimed to investigate the effect of exposure to continuous
darkness and continuous light on the contractility of the vasa deferntia smooth
muscles from rats to applied nor-adrenaline and 5-HT.
Method: Male albino wistar rats were divided into 3 experimental groups. Group 1:
Control animals, were exposed to the ordinary photoperiod each day. Group 2: Rats
were kept in a dark room. Group 3: In a room under a bright artificial light.
All animals were killed after 4 weeks.
Results: Vasa deferentia preparations from continuous dark group of rats exhibited a
reduced reactivity with a significant lower maximal response to 5-HT than those from
control rats. The maximal response in the control vasa deferentia preparations were
nearly doubled compared with that of the continuous dark preparation where as they
responded to exogenous nor-adrenaline with no significant difference from those of
continuous dark animals. Vasa deferentia of continuous light animals responded with
decreased reactivity and a smaller maximal response to both vasoconstrictors
compared with that of control animals.
Conclusion: It is concluded that changes in the rhythm of the photoperiod have
considerable effects on the reactivity of the vasa deferentia smooth muscle from rats
to applied nor-adrenaline and 5-HT

Background: Mental health of children has recently been
receiving increased attention in many parts of the world.
However, such attention has been lacking in developing
countries, particularly in the form of systematic research
Aim: The study aimed to find out the frequency of
behavior disorders in a sample of primary school children
and the different social and demographic factors that might
be related to this disorder.
Methods: The study is a cross-sectional one that included
918 primary school pupils in both urban and rural areas of
Baghdad. Rutter's questionnaire teacher's version was used
to assess the pupils, and the demographic data was obtained
by special questionnaire sent to the parents to be
completed.
Results: The rate of behavior disorder was found to be
49%, in both rural and urban areas, males had higher
prevalence rate than females. The disturbed pupils had
higher scholastic failure and their parents of lower
educational level and came from highly crowded houses,
they had higher rate of disrupted family by either death of
one of the parents or their father is married to more than
one wife.
Conclusion: There is high rate of behavior disturbances in
school aged children in Baghdad, associated with low
socioeconomic status, bereaved children and having fathers
married to more than one wife. The study shows that these
children have low scholastic achievement.

Background: The excess mortality associated with
rheumatoid arthritis is largely due to
cardiovascular disease. Rheumatoid arthritis is of
primary importance in atherogenesis. The intimamedia thickness of extracranial carotid arteries is a
measurable index of the presence of
atherosclerosis.
Objective: To assess carotid intima-media
thickness in rheumatoid arthritis by Doppler
ultrasound.
Methods: Fifty two Iraqi patients with rheumatoid
arthritis were studied and compared with another
fifty two, healthy individuals matched for age and
sex as a control group. Full history was taken and
complete clinical examination was done for all
individuals in both groups. Rheumatoid arthritis
diagnosis was based on The American
Rheumatism Association 1987 revised criteria for
the classification of rheumatoid arthritis. Carotid
intima-media thickness was measured by Doppler
ultrasound.
Results: There was a significant increase in the
frequency of increased carotid intima-media
thickness among individuals with rheumatoid
arthritis (44.2%) compared to healthy control
group (3.8%) (P=0.000001).
Conclusion: Increased carotid intima-media
thickness occurs in high frequency in rheumatoid
arthritis

Background: Ejection fraction have been used frequently
for assessment of the left ventricular function, but can be
associated with errors in which myocardial performance
index have been used as another parameter to measure the
left ventricular function.
Objective: selecting another echocardiography parameter
for the assessment of myocardial in function instead of the
ejection fraction.
Methods: 160 patients referred to the echocardiogram unit
from the period december 2007 to august 2008 requesting
assessment of left ventricular function. After clinical
examination, routine blood tests; chest x-ray and
electrocardiographic recording have been completed. All
patients informed to come for this unit after the first visit
monthly for three successive months. For the purpose of
comparison (30) thirty volunteers admitted to this study as
control having same age range. The (160) patients were
categorized into two groups.
Group (A) includes (70) patients with ischemic heart
disease with complications like pulmonary oedema,
myocardial infarction, recent admission to coronary care
unit because of recurrent severs chest pain. Group (B)
includes (90) patients with ischemic heart disease without
any of the above complications. Myocardial performance
index is done by using the four chambers view and pulse
wave and curser along the mitral inflow of the blood jet.
Results: Assessment of left ventricular function by using
the myocardial performance index in group A was more
significant than using the ejection fraction in comparison to
the control group (P value 0.02, 0.03 respectively) the same
was found in group B in comparison to control group (P
value 0.01; 0.05 respectively).
Conclusion The myocardial performance index (MPI) in
the control groups was 0.44-0.36 MS indicating that its
range is very narrow in the control group, The (MPI) in the
two groups of patients was high in comparisons with
control group

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Published
2009-06-30
Issue
Vol. 5 No. 1 (2009): Vol 5 No 1 (2009): AL-Kindy College Medical Journal
Section
Research Articles
How to Cite
Saeed BN, Salim F, ALsaynee M-, ALsaynee M-, Sunbul L-. The Use of Myocardial Performance Index (Mpi) in Assessment of Heart Function. Al-Kindy Col. Med. J [Internet]. 2009 Jun. 30 [cited 2024 Dec. 12];5(1):62-5. Available from: https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/726
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Background: Acute appendicitis is a common surgical
problem that is associated with an acute-phase reaction.
Previous studies have shown that cytokines and acutephase proteins are activated and may serve as indicators for
appendicitis.
Objective: The aim of this study was to evaluate of serum
levels of interleukin-6 (IL-6) in correlation to the severity
to acute appendicitis.
Methods: This is a prospective study from December 2008
to March 2009 of patients who had appendectomy in
Department of Surgery, Al-Kindy Teaching Hospital -
Baghdad/Iraq. Serum for estimating levels of interleukin-6
(IL-6) was taken pre-operatively. Depending on the
macroscopic evidence during the operation and the
histopathological examination of the specimens, the
patients were separated into 3 groups, group one with
negative appendectomy (normal appendix), group two with
non-complicated acute appendicitis (catarrhal,
suppurative), and group three with complicated acute
appendicitis (perforated, gangrenous). The
histopathological results were correlated with IL-6 values
statistically.
Results: A total number of 50 patients were included in
this study, 28 male (56%) and 22 female (44%). The mean
age was 23 year (ranged from 7 to 50). On histological
examination, there were 7 patients (14%) in group one, 29
patients (58%) in group two, and 14 patients (28%) in
group three. Serum IL-6 values gave true negative results
in 6%, true positive results in 82%, false negative results in
4%, and false positive results in 8%. We determined,
therefore, in the present study the sensitivity, specificity,
and accuracy of serum IL-6 were calculated as 95.34%,
42.85%, and 88% respectively.
Conclusion: Laboratory results should be considered to be
integrated within the clinical assessment. If used critically,
IL-6 can provide surgeons with complementary
information in discerning the necessity for urgent
operation

Background: Blood vessels injury is one of the most
common causes of medical emergencies that admitted to
hospitals and at the same time it regarded as one of the
most important causes of death. They may represent less
than 15% of all injuries; they deserve special attention
because of their severe complications.
Objective: The aim of the present study is to assess
anatomically the injures of major arteries and veins in the
lower limb with their management.
Methods: The present study extended from April 2006 to
February 2007, in which 65 patients with lower limb
vascular injury were examined in Emergency Department
and Forensic Medicine Department of Tikrit Teaching
Hospital in Salah-Aldin governorate. Diagnosis was made
by clinical diagnosis alone, or in combination with
angiography. Some surgical interferences as vascular
repair was carried out, but if not possible the interposition
graft was used by great saphenous vein for vascular
reconstruction.
Results: The total cases were 65 patients (49 males and 16
females), ranging from 16 years to 67 years with a mean
age of 41.5±6.4 years. Penetrating trauma was the main
cause of injury for 52 patients. Seventeen cases had
bilateral limbs vascular injuries. Arterial injuries were most
common in the femoral arteries, followed by the tibial and
finally the popliteal arteries. Vascular repair were
performed in 16 cases, while in 11 cases great saphenous
vein interposition graft were done. There were 17 cases
associated with venous injury, of which 11 cases had
surgical vascular repair, and 6 had vein graft interposition.
There were concomitant femur fractures in 2 cases, fibula
fractured in 3, tibia fractured in 1 and the foot bones
fractured in 3.
Conclusion: Lower limb vascular injured patient should be
transferred to vascular surgery centers as soon as possible.
After first aid management, anticoagulant treatment may be
started post operatively to prevent the propagation of the
thrombosis. Early fasciotomy is done if there is any
suspicion of occurrence of compartment syndrome.

ObjectiveIs to study the causes of bloody diarrhea in in (50)cases (37%) , Shigella spp in (25) cases (18% and
children under five years of age and to clarify their relations Campylobacter jejuni Icases only (0.75%)
to the type offood and mothers educational level ConciusionBloody diarrehea is common in children under
methods Ahospital based study was carried out at tikreet 5years age who were admitted to Tikreet Teaching Hospital
teaching Hospital in Tikreet city on 133 children who were in Tikreet city , There is astrong positive relationship
admitted to the hospital with bloody diarrehea their ages between the occurrence of bloody diarrehea and the type of
range between one month -5years. The period study is from food. Education of the mother plays an important rule for
(January200 I-July 2001). the occurrence of bloody diarrehoea, mostly those who
Results The pathogens causing bloody diarrhea were were illitrate

Background: The spleen is the most common solid
organ injured in patients who had sustained abdominal
trauma. Such injuries to the spleen represent
approximately one quarter of all blunt injuries of the
abdominal viscera.
Due to its remarkable vasculature and its fragile
structure, splenic rupture is the most widespread cause
of intra-abdominal hemorrhage.
Objective: To assess the magnitude of splenic injury,
the management of splenic injury, and to evaluate the
postoperative complications.
Methods: A prospective study of 57 cases of splenic
injury was performed in Al-Kadhimiya Teaching
Hospital during the period between the 1st of October
2004 and the 1st of October 2006. Statistical analysis
was then performed to identify the causes, management
and postoperative complications. Splenic injuries were
graded into 5 grades.
Results: The highest incidence of splenic injury was
recorded in age group s31-40 year. Penetrating injury
was much more common than blunt trauma (73.68%
versus 26.31%).
Fifty patients (87 %) were diagnosed by exploratory
laparotomy, ultrasonography in 5 patients (8.77 %), CT
scan was positive in 2 patients (3.5 %). Associated
injuries were recorded in 41 patients 71.92%.
Pulmonary complications were the most frequent
complications (18 patients, 31.57 %).
Conclusion: Splenic injuries are common surgical
problems in Al-Kadhimiya Teaching Hospital. Still
there are many difficulties in establishing the diagnosis
of the splenic injury with shortage in the new diagnostic
modalities especially (CT -Scan, MR1 and even U/S
scan) in the emergency situations.
In spite of the dangerous post-operative complications
of splenectomy, it is still the most commonly performed
surgical procedure in cases of splenic injury

Objectives: To evaluate the incidence of adhesions
induced intestinal obstruction after explorative laparotomy
due to bullet/shell injury in Al-Kindi teaching
hospital/Baghdad.
Results: Thirty-six out of the 76 cases with adhesions
induced intestinal obstruction (A.I.I.O.) had history of
laparotomy for penetrating missile injury, 26 of them were
explored as a method of management of A.I.I.O. with
mean age (22 for those explored, ٣٧ for those treated
conservatively), 16 of them presented within a year or less
from the previous surgery.
Methods: Comparative interventional prospective study of
cases with adhesions induced intestinal obstruction
admitted to the surgical wards in Al-Kindi teaching
hospital from the 1st of January 2008 to 31st of December
2008. cases were followed considering the indications of
previous laparotomies, the patients age, gender, duration
between previous surgery and their presentation with
intestinal obstruction
Conclusion: Cases required surgical interventions for
treatment were mainly those following explorative
laparotomy for penetrating missile injury they were mainly
of young age Groups

Congenital distal vaginal obstruction is usually asymptomatic in a newborn female. On rare occasions, it may present as an acute emergency with life threatening complications.This paper is reporting the rare condition of two newborn females presenting urgently with abdominal distension and acute urinary retention as a result of congenital distal vaginal Obstruction. The case history and urgent management shall be presented and both conditions shall be discussed.