Tikrit Journal of Pharmaceutical Sciences

Abortion generally presented as two types; the spontaneous and the induced abortion. Spontaneous one is the termination of pregnancy before fetal viability which occurs spontaneously. About 80% of spontaneous abortion losses occur in the first trimester, the incidence decreases with advance in pregnancy. Prolactin is a polypeptide hormone that is synthesized in and secreted from specialized cells of the anterior pituitary gland, the lactotrophs. The major action of prolactin is lactogenesis (milk production). It is the major hormone stimulating the production of milk. Prolactin seems to play an important role in implantation and subsequent placentation in the human endometrium, and it is recognized as a crucial signal for the initiation and maintenance of decidualization. In addition to that, prolactin inhibits the secretion of gonadotropin releasing hormone by the hypothalamus, and this inhibition lead to decreased secretion of luteinizing hormone (LH), which normally initiates ovulation, therefore with hyperprolactinemic state ovulation, does not occur (anovulation). The aim of this study is to study the effects of prolactin hormone in the incidence of abortion cases in first trimester pregnancy in women in Tikrit city. Serum Prolactin was measured by using kit made in France. VIDAS Prolactin (Made in Italy), for the enzyme immunoassay determination of human prolactin in human serum or plasma by using the technique of Enzyme Linked Fluorescent Assay (ELFA). One hundred and thirty four pregnant women were participated & finished the whole study; 56 normal pregnant women in first trimester as a control group and 78 women with different types of abortion in first trimester who are diagnosed by clinical examination and/or by ultrasonography as aborted group. Seventy eight aborted women were participating in the present study. Threatened abortion was the highest one among aborted women (44.9%). Followed by missed abortion (19.23%), incomplete abortion (14.1%), complete (9%), inevitable (7.69%) & the last is recurrent (2.57%). Regarding serum prolactin, there is a significant difference between normal pregnant women (47.1 ± 25.4 ng/ml) as compare with aborted women (69.4 ± 48.8 ng/ml). In another word, aborted women have a serum prolactin concentration than that of normal pregnant women (p≤0.01).

Diabetic cardiomyopathy has been proposed as an independent cardiovascular disease and many mechanisms, such as microvascular disease, autonomic dysfunction, metabolic disorders, and interstitial fibrosis, have been suggested as causative factors. However, the exact causes and mechanisms of diabetic cardiomyopathy remain unclear. Several studies have demonstrated evidence for preclinical left ventricular (LV) diastolic dysfunction in patients with diabetes mellitus (DM) independent of coronary disease or hypertension. The prevalence of diastolic dysfunction in asymptomatic patients with type 2 diabetes mellitus or its relation with other diabetic complications (nephropathy, retinopathy, and neuropathy) is not well defined and data are controversial. A case series study of ninety patients with type 2 diabetes mellitus was designed to determine the frequency of asymptomatic left ventricular diastolic dysfunction in type 2 diabetes patients and its relation to patients’ duration, control of diabetes and other factors, the setting was at Diabetes Clinic, Echocardiography Unit and wards of Ibn Sina Teaching Hospital. During the period from the 1st of July to 31st of December 2011, eighty seven consecutive normotensive diabetic patients type 2 (mean age 51.35+8.21 years) and having no coronary artery disease on non invasive testing, were studied for assessment of left ventricular diastolic function using pulsed Doppler at the tip of mitral valve, the peak late (atrial) transmitral flow velocity (A wave), the peak early transmitral flow velocity (E wave),the (E wave) deceleration time and the ratio between (E wave) and (A wave) were assessed. Tissue Doppler was also used to assess the basal septal (medial) mitral valve annular velocities, the peak early basal annular velocity ( E` wave ) and the peak late basal annular velocity (A` wave) in addition E/E` ratio was assessed, left ventricular diastolic function was classified as left ventricular diastolic dysfunction positive and left ventricular diastolic dysfunction negative, further classification in to normal, impaired relaxation and Pseudonormal groups was made, age gender duration of diabetes, atherogenic index, obesity were studied in relation to left ventricular diastolic dysfunction using Chi square and Fissures exact tests, T-tests and ANOVA were used to calculate means and to compare them

A successful induction of labor leads to vaginal delivery of a healthy baby, in an acceptable time frame with minimum maternal discomfort or side effects. To compare the efficacy and safety of sublingual and per vaginal 25μg misoprostol for labor induction. Primary outcome measures were the number of cases delivering vaginally, Secondary requirement, the incidence of meconium-stained liquor, number of cesarean deliveries, the incidence of hyperstimulation/tachysystole, maternal adverse effects and neonatal outcomes. A prospective study was conducted in Tikrit Teaching Hospital. Indications were reviewed; 416 women randomly received misoprostol 25 μg vaginally and sublingually every three hourly for maximum three doses. Outcomes were analyzed accordingly. The number of the cases who successfully delivered vaginally was greater in the sublingual group. The induction to vaginal delivery interval was significantly shorter in sublingual group. The incidence of tachysystole and meconium-stained liquor were more in the vaginal than in the sublingual group. The mean doses, mode of delivery, oxytocin augmentation and maternal outcomes were significantly favorable in sublingual group. No significant difference is seen in neonatal outcome. Sublingual misoprostol 25 μg administered three hourly for labor induction has better effficacy as compared to 25 μg of vaginal misoprostol.

Carpal tunnel syndrome (CTS) is one of the most common upper limb compression neuropathies. CTS account for approximately 90% of all entrapment neuropathies. An estimated one million adults from the United States (annually) have CTS requiring medical treatment. The aim of the study is to investigate to compare the normal values of median nerve of normal healthy women (distal latency, amplitude & conduction velocity) with the same values of median nerve in women with carpel tunnel syndrome. The study was conducted as a case series study for Iraqi volunteers and patients attended to rheumatology department - neurophysiology unit at Tikrit teaching hospital (TTH) at the period from the 1st of December 2010 to the 1st of August 2011. Forty healthy female subjects with a mean age of (40.315 ± 10.324 years) to compare with the CTS female patients. Thirty eight female patients with mean age group of (40.55 ± 10.230 years) with CTS affect them in right hand diagnosed by rheumatologist and neurologist then referred to nerve conductive study (NCS) and EMG unit at TTH. The NCS was done by using NIHON KOHDEN / Neuropack S1 EMG / EP Measuring System MEB-9400 MODEL 2009. There are no significance differences between control subjects & CTS patients regarding age, body mass index. Also, there are no significance difference between normal control subjects & CTS patients in regard to upper limb length, arm circumference, index finger length (IFL), index finger circumference and wrist circumference. In regard to motor activity of median nerve, there is significance increase in distal latency time of median nerve of CTS patients (5.632 ± 1.791 msec) on compare to normal control subjects (3.540 ± 0.622 msec). Also, the amplitude of action potential of motor activity of median nerve is higher in control subjects (9.217 ± 0.509 mv) in compare to CTS patients motor activity of amplitude of (6.530 ± 1.937 mv). The difference between median nerve motor amplitude is significance at ( p<0.01) between patients and controls. Moreover the conduction velocity in CTS patients of median motor (58.354 ± 1.789 m/sec) is significance lower (p<0.01) in compare to motor conduction values of median nerve in normal control subjects (53.744 ± 4.232 m/sec). However, in regard to sensory activity of median nerve in right hand of both normal control subjects and CTS patients. The latency period in CTS patients is delayed (3.414 ± 1.606 msec) in compare to normal subjects (2.761 ± 0.344 msec). While, the amplitude of action potential of the sensory activity of median nerve is significantly lower (p< 0.01) in compare to normal subjects. Also, the conduction velocity of sensory activity of median nerve of CTS patients is significantly lower (38.357 ± 4.357 m/sec) on compare to conduction velocity of sensory activity of median nerve of normal subjects (48.236 ± 2.545 m/sec). The present study concludes that: The present study showed abnormal values NCS of median nerve at CTS patients as compare to normal healthy women of same age. The present study recommend

A prospective study of 24 cases of infantile hypertrophic pyloric stenosis in Salahaldeen government from February 2008-february 2011. All patients evaluated according to family history, sex, age, age at starting of vomiting and hydration state. Examination done for any palpable mass and sign of dehydration, and muscle wasting ,feeding test done for all patients. Patients admitted to hospital and investigations done which includes complete blood picture, blood urea, serum electrolyte. All patients send for ultrasound study of the pyloric canal to evaluate the length and thickening of the pyloric canal and consider as appositive study if the length more than 14mm and thickening more than 4mm pyloromyotomy done for all case with very good result and most of patient discharge after 24h of surgery.

Acute appendicitis considered one of the causes of acute abdomen. The diagnosis is usually straight forward in typical cases, but this is not true in atypical cases. This study is to assess the value of ultrasound modality in diagnosing acute appendicitis. From January 2009 to January 2012 in Al-Ramadi teaching hospital, 196 patients were included in this study, 10 patients were excluded, and 186 examined by ultrasound, after adequate clinical assessment, for their signs and symptoms that suggestive of acute appendicitis. Age groups were 6-75 years, Mean age 33.5 years, with 105(54%) males, and 91(46%) females. 186 patients could be explained, and examined by ultrasound, with mean age of 33.5 years, the diagnosis had established in 34 patients. The false positive was three cases, and false negative was six cases, this means that the ultrasound had failed in these nine cases. The sensitivity is 81.8%, the specificity is 98%. 90% and 96.2% are the positive and negative predictive values respectively. The diagnostic accuracy is 95.5%. The P-value is