Thi-Qar Medical Journal

The aim of the current study was to compare antioxidant defenses and oxidative stress
markers in patients with Diabetes Mellitus (DM) and in those with Rheumatoid Arthritis
(RA). Across-sectional study was conducted with 74 participants in two distinct groups:
Diabetes Mellitus types 2, Rheumatoid Arthritis and healthy blood donors. Malondialdehyde
and uric acid were compared between these groups. Uric acid was measured as antioxidant
defenses tested in blood samples from (RA) and (DM), rather than the degree of lipid
peroxidation was measured in term of malondialdehyde (MDA). MDA level was 3.29 ± 0.59
µmol/L in control group which was significantly lower than in diabetic and Rheumatoid
arthritis patients 6.32 ± 0.84 µmol/L , 6.75 ± 0.77 µmol/L respectively with (p <0.001).
Moreover; concentrations of UA in DM was 3.65 ± 0.11 mg/dl significantly lower than in
control 4.56 ± 0.29 mg/dl with (p <0.001),conversely, we found that no significant change in
the level of UA in RA 4.23 ± 0.66 mg/dl, compared with health subjects 4.56 ± 0.28 mg/dl.
These results suggest that the feasibility to find out a new evidences for a possible
relationship between these pathologies can be found.

Objectives: Tonsillectomy is one of the operations most frequently performed by
otolaryngologists, who are in search of a technique of tonsillectomy where the operation time
and operative blood loss is reduced. This study was carried out
to evaluate the effect of hydrogen peroxide 3% in comparison with iced normal saline on
tonsillectomy times, blood loss during the surgery and on the number of packs used.
Methods: Analytical cross sectional study was performed on thirty patients was carried out in
the Department of Otolaryngology of AL-Habbobi General Hospital,AL-Nassyria, Iraq, in the
period from the 1st week of March 2010 till the last week of November 2010. Tonsillectomy
was performed using hydrogen peroxide 3% as a haemostatic agent in Group A(n = 15
tonsils), while in Group B (n = 15 tonsils) iced normal saline was used where as no agent was
used with the gauze pack in GroupC(n=30 tonsils).
Results: The application of pack socked with hydrogen peroxide 3% or iced saline in the
tonsillar fossae reduced the operation time , the operative blood loss and also reduced the
number of packs used in Group A and B in comparison with non agent method . The results
were statistically significant.
Conclusion: The local application of 3% hydrogen peroxide on the tonsillar bed after
tonsillectomy is beneficial to decreasing the volume of blood loss more than other
applications;while no significant difference between group A and B regarding the number of
packs used and duration of operation

Purpose:
To evaluate the role of extracorporeal shock wave lithotripsy (ESWL) in the management of
upper ureteral stones.
Patients and methods
Between May 2009 and June 2011, 115 patients with radio-opaque upper ureteral stones
who referred to lithotripsy unit in Al-hussain teaching hospital in Thiqar, 83 male( average 48
years) and 32 female (average 51years), treated with extracorporeal shock wave lithotripsy
(ESWL). The patients were discharged from the hospital on the same day of treatment and
patients were asked to return after two weeks for fallow up plain film together with ultrasound
examination, to be able to detect fragmentation and stone clearance together with the effect of
treatment and obstruction on the upper tract.
Results
The over all success rate for the patient at 3 months of follow up was 64.3% (74 pt.) the
success rate decreases as the stone size increases. It decrease from 76% to patients with stone
<10 mm to only 52% to patients with stone > 15mm. The remaining 41 patients (٣5.6%) were
considered failure, either due to non fragmentation of the stone despite repeated sessions (3
sessions) or fragments are large that failed to pass (5 cases). All patients were treated on an
outpatient basis; the complications were minimal and treated conservatively.
Conclusions
ESWL is safe, effective, noninvasive and a convenient way of treatment for upper ureteral
stones. ESWL being an outpatient procedure without any need for anesthesia or any
pretreatment intervention, it should be considered as the first line of treatment for all stones in
the upper ureter. However the clearance rates for stones larger than 15 mm were low.

OBJECTIVES: To study the prevalence of hand abnormalities in diabetic patients and to
evaluate the associations between the hand abnormalities and diabetic variables .
DESIGN: Cross-sectional study of 248 diabetic patients selected at random, setting , Out
patient clinic,diabetic centre ,AL- Nassriah city .
MEASURES: Presence and extent of carpal tunnel syndrome (CTS), Dupuytren's contracture
(DC), flexor tenosynovitis (FTS), and limited joint mobility (LJM). Duration of diabetes,
metabolic control .
RESULTS: Carpal tunnel syndrome, DC, FTS and LJM were each present in significant
number. Hand abnormalities were observed in 39.5% and more than one abnormality was
also found in a significant number.. The hand abnormalities were associated with the duration
of diabetes but not with the metabolic control .
CONCLUSION: The prevalence of hand abnormalities in diabetic patients is high and
increases with the duration of diabetes. ,but not the glycaemic control.

Background and Objective : Amebiasis caused by Entamoeba Histolytica (E.H) is a
common problem in areas with poor hygiene . Metronidazole is abroad antiprotoza agent used
in symptomatic or asymptomatic infection .
Aim of Study : To findout which idial course duration 7 or 10 days and which logical
effective dose 30 mg / kg or 50 mg / kg for treatment of amebiasis beside effect the dose on
platelets .
Method : Prospective study was conducted on ( 171 ) hospitalized patient at Bint– Al-Huda
hospital during the period from the 1st of May 2010 to the 1st of May 2011 , suffering from
amebic colitis .
The patients divided for four groups . Group A ( 45 ) patient treated by 30 mg/kg and group B
( 47 ) patient treated by 50 mg/ kg for 7 days . Group C ( 38) patient treated by 30 mg/ kg and
group D ( 41 ) treated by 50 mg / Kg for 10 days .
The diagnosis of amebiasis depend on positive fresh stool sample for E.H trophozoites and
followed more than once . Platelets count performed for all patient at the end of each course .
Result : The 7 days treatment course cure ( 86.6 % ) of patient from group A and ( 89.4% )
for group B, while 10 days treatment course cure (94.4%) of group C and (96 %) for group D.
Duration of bloody diarrhea in group A was (89. +
14 hrs), group B (86.+
( 85.2 +
17.76 hrs ) and group D was (83. +
21.98hrs) , group C
14.97) . So the dose difference 30 mg/ kg or 50
mg/ kg not affect the duration of bloody diarrhea significantly . P value > 0.05 .
One patient from group D develop thrombocytopenia , four patients develop dark urine in
presence of normal heamostasis .
Conclusion : Amebiasis is a great problem in our locality and 30 mg / kg for 10 days of
metronidazole course so effective equally to that 50 mg/kg , therefore the former course
looked more logical unless the infection so severe , because the less dose administration the
least side effects . Effect the dose and duration of metronidazole on platelets need to be
investigated more .

Background: Little is known about the pattern and burden of cancer in Thi-qar city. The
aim of this paper is to report the pattern and distribution of cancer in largest series of Thi-qar
cancer patients according to the year of diagnosis ,age , gender ,topography ,morphology and
geographical distribution.
Patients and methods : During a five year period (2005-2009). 3523 cancer patients,
with various types of newly diagnosed cancer were registered by Cancer Control Unite in Thi
qar from all Health Institutions in Thi-qar and in other neighboring Governorates . 1702
patients were males (48.3%) and 1821 were females (51.7%). Adding that around of 1458
patient(41.4%) of a total were died within this period. The crude relative frequencies(rates) of
extent of cancer risk(incidence &mortality) have been determinant with reference to age,
sex, area and year of diagnosis.
Results: The number of cancer cases and the incidence rates are increased among these five
years, where is the number is 436 and IR 28.7per 100000 of population in 2005 while it is
804 and IR 46.9 in 2009 .This gives an average annual incidence or a crude annual incidence
rate(IR) of 43.6 cases per100000of Thi-qar population per a year and the incidence is more in
females than in males(48.3%for males and 51.7%for females). Higher number of cases were
drawn from population of the center of the governorate 1455(41.3%), while lesser number in
Al-Jabiash District 265(7.5%) and other district lie in between. Breast cancer is the most
common or frequent cancer accounted for( 16.5%) of all cases and it alone accounted for
31.2% of all cancer in females with the incidence rate of 7.2/100000 of population , lung
&bronchus is the second (11.2%), bladder was the third of all cancer cases(10.6%), while
other cancers as cancers of prostate and skin were less frequent incidence. The four most
commonly diagnosed types of cancer in males are :lung &bronchus ,u. bladder, lymphomas
and leukemias , accounting for 53.9% of estimated cancer cases in males. The four most
commonly cancer in females are: Breast ,leukemia ,u. bladder, and lymphomas accounting for
53.5% of estimated cancer cases in females. Cancer risk infected all age groups in different
percentages and the age specific incidence rate (ASIR) increased with advancing ages in both
sexes, higher rates are noticed in male children compared to female children up to age 14 . In
addition, the risk of cancer is higher for females(sex-specific incidence rate is45.3per 100000
population) than for males (sex-specific incidence rate is41.9 per 100000 population). The
number and percentage of death cases are also increased during these five years, it is more in
males than in females ,and the average annual number of death is 292 or the crude annual
death rate is 18/100000 of population.
Conclusion: Cancer is existed growing health problem in Thi-qar cancer patients, it's with
specific pattern and with different etiological factors.

Background and Objective : The brachial plexus are injured mostly due to severe lateral
traction of neck during delivery mainly in shoulder dystocia , large baby and prolonged
labour .
Method : A prospective study was carried out on (26) cases of brachial plexus palsy . The
information depend on clinical examination at nursery care unit and delivery room notes at
Bint Al-Huda Maternity and Pediatric Teaching Hospital in Al-Nassirya city through out
2009.
Results : Brachial plexus palsy ( BPP ) is found in ( 1.5 per 1000 live birth ) of total delivery
and usually type Erb's palsy (80.8%) more than Klumpke (7.7%). Shoulder dystocia (38.8%) ,
Macrosomia (23 %) , Prolonged labour ( 15.3 % ) were significant risk factors for BPP .
Male ( 53.8 % ) affected little more than female ( 46.2 % ) and right side ( 61.5 % ) more
affected than left side ( 38.5 % ) .
Most cases of Erbs ( 76 % ) improve with time opposite to that of Klumpke type ( 3.3 % )
during the period of follow up for 6 months .
Conclusion : BPP still a problem in our overload delivery room . Well trained medical staff
necessary beside education about risk factors of BPP .

The activity of alkaloids compound extracted from Chlorophyta and Cyanophyta were test
against pathogenic bacteria and fungi without parasites ,thus, the present study has aimed to
test the activity of alkaloids as antiparasite for the first time in Iraq and against Hydatidosis
among
the
world
.The
present
study
has
resulted
that
2-(N,N
dimethylhydrazino)cyclohexanecarbonitrile compound has activity against the protoscolices
at five days–post treatment in vitro and in low concentration from that used with
albendazole.

This study reports the prevalence of hepatitis A Virus (HAV), hepatitis B virus (HBV) and C
virus (HCV), and the frequency of potential exposure to these viruses among patients were
admitted to Hormones laboratory in Al-Hussain teaching hospital /Thi-Qar province. Serum
samples were tested for HAV , HBV markers and antibodies to HCV by enzyme-linked
immunosorbent assay (ELISA).
From the results of the present study , 2775 patients were tested, divided into tow groups.
Group A included the catheter patient and other group (Group B) included outpatient. Results
showed no positive result for anti- HAV. While, Anti-HBs were positive 4 cases and 6 cases
for group A and group B respectively. Contrast, anti- HCV were positive 2 cases for group A
and 5 cases for group B. Statistically significant observation P<0.05 between the two groups,
Group B was the highest sensitive to Hepatitis B,C infection than group A .
Background: Diagnosis is a vital decision point at which adequate evidence has to be
accumulated to get a clear clinical picture about the patient before initiation of the treatment .
Laboratory tests for hepatitis are very critical for the physician to confirm his findings about
the clinical condition of the patient because of several causative agents of the disease.
Hepatitis being caused by the virus A,B,C diagnosis is even more complicated as all of them
present similar symptoms. Therefore, laboratory testing is important to identify the exact
causative virus so that the appropriate treatment can be initiated accordingly.

This study was designed to investigate the possible developmental fetotoxicity and
teratogenicity of Norfloxacin (NFX), Ciprofloxacin (CPX) and Enrofloxacin (ENX) in rats.
Eighty pregnant female rats were divided into four equal groups, the first three groups were
given daily single oral doses of NFX,700mg/kg/day, CPX 550mg/kg/day, and ENX
750mg/kg/ day respectively and the last group was given dimethyl sulphoxide ( DMS) 0.5
ml/animal/day. All animals administered the drugs and the vehicle from the day 1 to the day
15 of gestation period . Ten animals from each group were sacrificed at day 15 of gestation
by cervical dislocation, the other ten animal from each group were left till labor. Embryos and
pups were evaluated for litter size ,weight, resorption ratio, fetal lost and external features .
The effect of drugs on the length of gestation period was also evaluated . The results
revealed that fluroquinolones were significantly decrease litter size, and fetal weight, and
increase fetal resorption ratio and fetal lost as compared to control either fetuses evaluated at
day 15 of pregnancy or those evaluated after birth . Gross examination showed some
teratogenic abnormalities in fetuses and pups of mothers treated with fluoroquinolones during
the first 15 days of pregnancy .

Objective: To evaluate the obstetrical complications and neonatal outcome of teenage
pregnancies in comparison with older group. Setting : This study was carried out in Al
Basrah General hospital from 1st of October 2010 to 31st of March 2011. Study design: This
study included 116 primigravida women aged 15-19 year as a case group & 116 rimigravida
women aged 20-24 year as a control group admitted to labour word during the period of
study, all women recieved standared labour management in cluding history & complete
general & obstetric examination. Both groups were compared for the presnce of any
pregnancy complication & for the mode of delivery and Neonatol outcome also compared
between the two groups. Results: teenage mothers had a higher proportion (15.5%) of
preterm deliveries compared to (4.3%) in the adult mothers and had higher proportion of low
birth weight babies (19,8%) compared to adult mothers.(6.89%).

Background:The metabolic syndrome ( syndrome X ) , also called "insulin resistance
syndrome" is a cluster of cardiovascular risk factors associated with excess fat. the metabolic
syndrome is more common among women with PCOS than in normal women), particularly in
those with hyperinsulinaemia and obesity
Objective: The Aim of the study was to determine the prevalence of metabolic syndrome,
and it’s main determinants in women with PCOS.
Methods: Two–hundred twenty women , 105 patients with polycystic ovary syndrome (
PCOS) and 115 control , were included in this study to determine the prevalence of the
metabolic syndrome & its main determinants among women with PCOS .
Results: The study revealed that 82.1% of women with PCOS were nulliparae compared to
8.91% of controls ( P < 0.001) . Blood pressure > 130/ 85 mm.Hg and waist circumference >
88 cm were found among 37.14% and 60% of patients with PCOS respectively in comparison
to 12.17% and 25.2% of control women respectively ( P <0.001). Over weight and obesity
were observed among 48.6% and 40% of PCOS women respectively compared to 25.2% and
12.2% of controls respectively ( P < 0.001) . Only 3.3% of patients with PCOS were fertile ,
73.9% with primary infertility and 22.8% with secondary infertility . The comparative figures
among controls were 82.3% , 4.2% and 13.5% ( P < 0.001) . The main menstrual disorder
associated with PCOS was oligomenorrhoea , observed in 72.4 of patients , compared to 3.5%
in control women ( P < 0.001) . Hirsutism was found among 62.9% of PCOS patients in
comparison to 5.2% of controls ( P < 0.001) . Women with PCOS showed significantly higher
FBG , TC, TG and LDL-C levels ( P < 0.001) and significantly lower HDL-C levels ( P <
0.01) compared to control women .
The frequency of metabolic syndrome in PCOS was 34.3% compared to 6.1% in conrol
women ( P <0.001) .
Conclusion : the prevalence of metabolic syndrome in PCOS is nearly 6 times higher than in
controls . Women with PCOS share multiple cardiovascular risk factors , and thereby , more
prone to cardiovascular events .

Objective: the aim of this study is to determine the biochemical markers predicting the
development of diabetic retinopathy and the relationship between them.Method: a blood
samples were collected from 100 diabetic patients classified into two groups:
Group 1 consisted of 50 diabetic patients (30 females and 20 males) aged between 19-70
years without diabetic retinopathy (DR) proved by clinical evaluation performed by the
ophthalmologist; Group 2 consisted of 50 diabetic patients (23females and 27 males) aged
between 20-78 years with diabetic retinopathy proved by ophthalmologist.
They were attending a private ophthalmology clinic in Basrah during the period from 1st of
February 2010 to the 1st of August 2010.
HbA1C was measured using cation-exchange resin to separate HbA1C from other types of
HbA1C and measured spectrophotometrically.

Objective:
To study the factors affecting the rate of perforation in patients with acute appendicitis with
view of adding to local data and comparing our results with other local and international
studies.
Patients and Methods:
Aprospective study carried out on 135 pts. treated by emergency appendicectomy at Al-Sadar
Teaching Hospital from June 2003– 2004, they were divided according to their operative
findings, into tow groups, those with acutely inflamed non perforated appendix (109 pts.) and
those with perforated appendix (26 pts.). All the data collected were analyzed using Z-test.
Results:
The highest incidence of acute appendicitis (non perforated and perforated) was in the age
group 21-30 years (52 pts.; 38.5%), while the lowest incidence was in the age group below 10
years (8 pts.; 5.9%) and above 60 years (6 pts.; 4.4%), in addition ,the highest incidence of
perforation was in the age group over 60 years (3 pts.; 50%) and below 10 years (3 pts.;
37.5%),while, the lowest incidence was in the age group 21-30 years (5 pts.; 9.6%),however,
the overall incidence of perforated appendicitis was 19.3% (26pts.). The mean time of delay
from the onset of the abdominal pain to the operating room was 23 hours and 41 hours in the
non perforated and perforated groups respectively with pre admission and post admission
delay were 16 and 5.40 hours respectively in the non perforated group in contrast to 35 and
5.54 hours respectively in the perforated group.
More than 65% of both groups reached the operating room within 6hours from their
admission to hospital.
Conclusion:
Differences in the length of the pre hospitalization phase of the disease play an important role
in increasing the rate of perforation in patients with acute appendicitis in addition to other
patient’s related factors particularly age.
Variation of few hours in the timing of surgical operation after admission appears to be less
contributory factor to perforation and lastly, a second opinion from senior colleague is
warranted for diagnosing an equivocal case.