Thi-Qar Medical Journal

Backround
AVNRTis the most frequent type of regular paroxysmal Supraventricular Tachycardia
(SVT) .Catheter Radiofrequency Ablation (CRFA) has been recommended as first line
therapy for curing AVNRT.
Objective
This prospective study was conducted at AL-Kadhimiya Teaching Hospital from
January 2004 to July 2006 to report the 2 years experience of CRFA of the slow pathway
in patients with recurrent attacks of AVNRT refractory to medical therapy treated at
our Electrophysiology laboratory (EP Lab.) and assessed for success rate and
recurrence rate after CRFA.
Patients And Methods
Fifteen patients selected after diagnosis of typical AVNRT and been considered as
refractory to drug therapy when the full single or combined antiarrhythmic therapy
gave poor control. AVNRT diagnosed when the superficial ECG and the EP study
showed: a, regular narrow complex tachycardia. b, no p wave or short RP long PR .c,
VAinterval < 55 msc. d, dual AVN conduction and AH interval jump. CRFA done with
the use of a standard EPS with three diagnostic catheters and one RF Ablation catheter .
AVNRT induced either spontaneously or by programmed atrial stimulation . Ablation
done during tachycardia in 11 patients and during sinus rhythm in four . Slow pathway
ablation done using a combined electrophysiological and anatomical approach The
primary endpoint of CRFA was termination and or non-inducibility of AVNRT.
RESULTS: Acute success was achieved in 15 patients (100%) . The total procedure
time ranged from 30 minutes to one hour .The average fluoroscopy time was 10.5-+ 4.5
minutes .The patients were followed up for a mean of 15+- 3 months during which there
was only one case of recurrence cured by a second CRFA . Complete heart block is the
only complication and seen in one patient who needed permanent pacemaker
implantation.

SUMMARY
This study was designed to investigate the efficacy of 40000MW dextran instead of
adrenalin in prolongation of the duration of action of local anesthesia in high risk
patients. Surgery was performed under local anesthesia ,lignocaine 2%with either
dextran 40000 MW or adrenaline ,sciatic nerve and three in one block. The results
showed no significant variations between the duration of action when the lignocaine 2%
used with dextran or adrenaline. Accordingly, dextran is a good alternative for
adrenaline in prolongation of local anesthesia in high risk patients.

A cross sectional study was carried out in Nassiriyah city, southern Iraq from 1st of
February to 20th of May 2007. The main objectives of the study were to describe selected
variables related to fertility, morbidity, mortality, socio-demographic characters, utilization
of prenatal care and immunization. The study included 264 families (1432) persons. The
study was a household survey done in four different areas in Al-Nassiriyah city (Hay Ur,
Hay Al-muntazah, Hay Al-Iskan. Hay Sumer). These quarters are located on both sides of
Euphrates which traverse the city from north west to south east, and of different
socioeconomic and demographic characterstic. Interviews were made to each family about
the age, sex, marital status, level of education, no. of families in house, any death or birth
in the last year, any current pregnancy with ascertainment of trimester, any acute illness
during the 2 weeks prior to the day of interview & the action taken in response to such
illness. Chronic conditions were also inquired about & the level of utilization of prenatal
care by pregnant women & immunization by children aged under 2 years were explored. In
the family(whether acute or chronic) & the action was taken by family. The result showed
that the population is highly fertile (crude birth rate = 41.2/1000) but suffer from high
mortality ( crude death rate=25.1/1000).Also 17% reported to have acute illneses during a 2
weeks recall period & 8% had chronic diseases. Use of prenatal care was practice by 75%
of pregnant women & 41.2% of children aged less than 2 years had complete immunization.
Further 45% had partial immunization. Illiteracy is high and only 13%of the population
are engaged in governmental jobs.

Background: Human milk is the ideal and uniquely superior food for infant for first
year of life . Some sociodemographic factor correlate most strongly with the prevalence
and duration of breast feeding.
Objectives: To determine the prevalence of breast feeding and factors influencing the
feeding practices in a study population in Thi qar governorate.
Design: Cross– sectional study.
Methods: in three hospitals in Thi qar governorate , the mother of infants in the
primary health care units of these hospitals , had been randomly selected and
interviewed with a questionnaire which included information about the age , sex and
mode of feeding for the infants , and the sociodemographic status of the mothers. The
sociodemographic variables included , urban / rural residence, educational level ,
occupation or employment , family income , place and type of delivery and contraceptive
use .
Results: the prevalence of breast feeding was 90% , and bottle feeding prevalence was
10 % the mean time of weaning was 11 months .Factor that were significantly
associated with duration of breast feeding were maternal age , level of education , area
of residence , occupation , family income , place and type of delivery and contraceptive
use . The most common reasons for refusing to breast feed were in adequate secreted
and the mother employment outside the home .
Conclusions: the prevalence of women nursing breast feeding was higher than the
estimated national data the prevalence of the bottle– feeding was higher in women who
needed to work out of their homes and in those with higher educational level

Background: The mechanism by which the orthostatic hypotension and cardiac
autonomic neuropathy increase cardiovascular morbidity and mortality remain to be
settled. Some studies found exercise intolerance in patients with cardiac autonomic
neuropathy with a reduced response in heart rate and blood pressure and decreased
cardiac output during exercise. An association between cardiac autonomic neuropathy
and QTprolongation has been shown.
Objective: To asses the role of the orthostatic hypotension in the development of the
early cardiovascular complications in the patients of the coronary care unit.
Patients and method: In this a prospective observational follow up study, (50) patients
with ischemic heart diseases were included. Blood pressure was measured with the
standard mercury sphygmomanometer, the measurement in supine position was taken
after at least 15 minutes of rest and the measurement in standing position was taken at
the third minutes of standing, the orthostatic hypotension is said to be present when
there was a sustained drop in systolic (≥ 20 mmHg) or diastolic (≥ 10 mmHg) blood
pressure at the third minute of standing up.
Results: Out of twenty two patients with orthostatic hypotension fifteen patients
developed cardiovascular complications and out of twenty eight patients without
orthostatic hypotension five patients developed cardiovascular complications, this
association is statistically significant
Conclusion: Orthostatic hypotension can be used as a prognostic marker for the
development of early adverse outcomes in patients with acute coronary syndrome, thus
it can be useful tool to screen the high risk patients in the coronary care unit.

Purposes: to assess the different factors responsible for failure of posterior
urethroplasty in recurrent stricture methods :- from "February 2000-december 2007"
17 patients (6-60 years)with failed urethroplasties under went redo urethroplasty for
post traumatic posterior urethral distraction..Bulbo prostatic anastomosis was done
through perincum in "15"patients and by perineo- abdominal transpubic in
"2"patients.The operative records of all patients was registered and followed for (6
month-2years).
Results: There was failure in "2"cases (8%) ,satisfactory in 6 patients (30%) and
successful in 9 patients (62%).
Discussion: The causes of failure and satisfactory results was in complete excision of
the scared prestatic apex in ability to achieve tension-free- bulbo prostatic anastomosis
and inpropper lateral fixation of prostatic mucosa on sides.
Conclusions: Redo urethroplasty considered one of obstacls in urology ,that should
be done by effecient,experts hands (urologist),that stick to the rules of surgical
procedure (complete excision of fibrous tissue,lateral fixation of the prostatic mucosa
and tension free-bulbo-prostatic anastomosis).

The present study aimed to determine the immune states against rubella in women
underwent abortion by detecting the levels of IgM and IgG immunoglobulins in their
sera. The study included a collection of venous blood samples from three hundred
women underwent abortion whose ages ranged from (15-35) years were Al-Najaf
governorate.Enzyme- linked immunosorbant assay (ELISA were used to determine the
immunological response against rubella virus in our samples. ELISA test reflected a new
infections which was (4.6 %) positive results. Anti-rubella IgG antibodies ELISA test
revealed (77%) positive result .

SUMMARY
Twenty mice were injected i.p. with 1x105 P. berghei infected red cells . Blood smears
of these mice were prepared daily till the mice were died . Mice were categorized in
three groups depending on similar type of course of parasitaemia after inoculation .
Seven mice of Group A (A1– A7) showed similar type of behavior and died due to low
parasite infection . Another group of seven mice (B1 to B7) showed a gradual increase in
parasitaemia till mice died due to high infection . Group C (C1 to C6) smears showed a
vary rise and fall in infection and all the mice were cleared of parasite infection .
The antibody titre as detected by IFA , observed in these groups was 1 : 2048 , 1 : 1024
and 1 : 4096 in groups A , B and C respectively . The group C which showed protective
immunity against P . berghei infection depicted strong fluorescence against normal
erythrocyte membrane too . The fluorescence against normal RBCS membrane was
observed very weak in group A , whereas it was negligible in group B .

Background:
long term complications of DM including atherosclerosis, neuropathy,
nephropathy and diabetic foot are the major causes of morbidity and mortality in
diabetic patients.
Objective: To study the effects of the control and duration of diabetes on the
development of long term complications in diabetic patients.
Method: The long term diabetic complications (neuropathy, IHD, CVA, PVD and
diabetic foot) were assessed in 80 diabetic patients of type 1 and type 2 who attended the
diabetic clinic in AL-Sader teaching hospital over 10 months period.
Results: There was significant relationship between the prevalence of long term
complications and degree of diabetic control and duration of diabetes mellitus
Conclusion: The control and duration of diabetes mellitus are the major predictors of
long term diabetic complications.

This paper focused on the isolation of different genera of fungi from 80 soils samples in 9
stations in Salahaddin Province, north of Baghdad ,IRAQ. According to different
environmental factors , these genera include Aspergillus ,Penicillium, Rhizopus, Mucor,
Botrytis, and Epicoccum. They were isolated by dilution plate method and soil washing
technique using the culture media viz. P.D.A., SAB. and MEA. The most widespread
genera were Aspergillus and Penicillium followed by Rhizopus , Mucor , Botrytis, and
Epicoccum respectively. P. brasilianum Batista. was identified and used for antibacterial
production. Other results in this paper were included.

SUMMARY
1- From1st of march2005 to 29th of February 2006. 1000 children under 5 years age with
acute gastroenteritis seen in outpatient and inpatient departments of child and
maternity teaching hospital in the city of Nassiryia were studied .
2- OneHunderdchildren under 5 years of age admitted to the hospital for reasons other
than vomiting and diarrhea, were randomly selected and regarded as control.
3- Stool specimens of both study and control patients were examined for the presence of
HunmanRota Virus antigen by latex agglutination test(LA) .
4- HumanRotaVirus antigen was detected in stool samples of 39% of the study cases and
2%of the control group.
5- Theantigen was detected more in specimens of infants particularly those between 6-18
months of age.
6- Theincidence of infection was lowest among exclusive breast–fed infants.
7- Males were more commonly affected than females , but no difference was seen among
different socio-economic classes.
8- HumanRotaVirus antigen was detected throughout the period of the study with
significant increase during winter months.
9- Children with acute Rota Virus gastroenteritis have certain clinical features and
laboratory result, these features and results collectively can be of help in presumption of
a clinical diagnosis for the condition .

In a prospective study extended along an 8 months period from July 2006-Feb .2007 ,
116 patients were collected , from the admission to the department of pediatrics ,
Maternity and children hospital in Nassiryia city (MCH), with suspicion of meningitis
.they were clinically evaluated for the signs and symptoms of meningitis , and the
CSF analysis was the final diagnostic tool for meningitis .the patients were divided
into 6 age groups ,and the sensitivity , specificity ,positive predictive value and the
accuracy for the symptoms and signs of meningitis were calculated for each age
group .
In the age group <1 month of age :convulsion was the most sensitive symptom, while
lethargy was the most sensitive sign .
In age group 1-6 months : fever and convulsion were the most sensitive symptoms ,
while bulging fontanel , lethargy and irritability were the most sensitive signs .
In the age group 7-12 months : vomiting ,fever and convulsion were the most
sensitive symptoms , while bulging fontanel, lethargy and neck rigidity were the most
sensitive signs .
In the age group 1-5 years : vomiting headache ,fever and anorexia were the most
sensitive symptoms , while lethargy and neck rigidity were the most sensitive signs .
In the age group 6-10 years : vomiting ,headache and fever were the most sensitive
symptoms , while neck rigidity was the most sensitive sign .Irritability ,Kernig sign
and back pain were less sensitive signs .
In the age group 6-15 : vomiting ,headache and fever were the only sensitive
symptoms while lethargy, Kering sign and neck rigidity were the only sensitive signs
From this study we can conclude that for each age group there are some signs and
symptoms
sensitive for the diagnosis of meningitis different from the other age
groups ..Performing lumber puncture in doubtful cases of meningitis is better than
missing a case of meningitis with it is sequelae.

This paper reports the results of study carried out in Al– Nassiriya city in the center of
diabetic and endocrine glands from the period of 1.7.2008-30.8.2008. It aims at
quantifying HbA1c ratio in diabetic patient from type 1 and type 2 to show the well or
poorly control diabetes mellitus.in this study has been collected 50 patient randomlly
(male 21 and 29 female), in different age from 7-65 years old.
Result :The percent of patients with Glibenglamide drug was 24% same percent with
repaglinide ,but the repaglinide improve glyceamic control without causing weight gain
or sever hypoglycemia and provides complete control by effectively reducing fasting
blood glucose and HbA1c compared to glibenglamide ,metformin and insuline.The
percent with Glibenglamide drug taken with metformin it was 27%,the same percent in
patient with insuline drug. Conclusion :controlled diabetes ,not much glycosylated
hemoglobin represented in a vocational diploma or college degree constituted of cases
,while uncontrolled diabetes ,much more glycosylated hemoglobin represented in
illiterate case.